Growth in Chronic Kidney Disease

Halima S. Janjua, John D. Mahan

Research output: Contribution to journalReview articlepeer-review

Abstract

Poor growth is a common sequela of CKD in childhood. It not only affects the psychosocial development of a child but also has significant effects even in the adult life. The multifactorial etiology and severe consequences of growth failure in CKD warrant evaluation of all the modifiable and nonmodifiable causes. Treatment strategies must be directed toward the specific factors for each child with CKD. Among the various metabolic, nutritional, and hormonal disturbances complicating CKD, disordered growth hormone (GH) and insulin-like growth factor-1 axis are important contributors toward poor growth in children with CKD. CKD is recognized as a state of GH resistance rather than GH deficiency, with multiple mechanisms contributing to this GH resistance. Recombinant GH (rGH) therapy can be used in this population to accelerate growth velocity. Although its use has been shown to be effective and safe in children with CKD, there continues to be some uncertainty and reluctance among practitioners and families regarding its usage, thereby resulting in a surprisingly low use in children with CKD. This review focuses on the pathogenesis of growth failure, its effect, and management strategies in children with CKD.

Original languageEnglish (US)
Pages (from-to)324-331
Number of pages8
JournalAdvances in Chronic Kidney Disease
Volume18
Issue number5
DOIs
StatePublished - Sep 2011
Externally publishedYes

Keywords

  • Children
  • CKD
  • Growth failure
  • Recombinant growth hormone

ASJC Scopus subject areas

  • Nephrology

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