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Multicenter Study
. 2014 Jan;9(1):92-9.
doi: 10.2215/CJN.00890113. Epub 2013 Oct 31.

Adult height in patients with advanced CKD requiring renal replacement therapy during childhood

Jérôme Harambat  1 , Marjolein Bonthuis, Karlijn J van Stralen, Gema Ariceta, Nina Battelino, Anna Bjerre, Timo Jahnukainen, Valérie Leroy, György Reusz, Ana R Sandes, Manish D Sinha, Jaap W Groothoff, Christian Combe, Kitty J Jager, Enrico Verrina, Franz Schaefer; ESPN/ERA-EDTA Registry
Collaborators, Affiliations
Multicenter Study

Adult height in patients with advanced CKD requiring renal replacement therapy during childhood

Jérôme Harambat et al. Clin J Am Soc Nephrol. 2014 Jan.

Abstract

Background and objectives: Growth and final height are of major concern in children with ESRD. This study sought to describe the distribution of adult height of patients who started renal replacement therapy (RRT) during childhood and to identify determinants of final height in a large cohort of RRT children.

Design, setting, participants, & measurements: A total of 1612 patients from 20 European countries who started RRT before 19 years of age and reached final height between 1990 and 2011 were included. Linear regression analyses were performed to calculate adjusted mean final height SD score (SDS) and to investigate its potential determinants.

Results: The median final height SDS was -1.65 (median of 168 cm in boys and 155 cm in girls). Fifty-five percent of patients attained an adult height within the normal range. Adjusted for age at start of RRT and primary renal diseases, final height increased significantly over time from -2.06 SDS in children who reached adulthood in 1990-1995 to -1.33 SDS among those reaching adulthood in 2006-2011. Older age at start of RRT, more recent period of start of RRT, cumulative percentage time on a functioning graft, and greater height SDS at initiation of RRT were independently associated with a higher final height SDS. Patients with congenital anomalies of the kidney and urinary tract and metabolic disorders had a lower final height than those with other primary renal diseases.

Conclusions: Although final height remains suboptimal in children with ESRD, it has consistently improved over time.

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Figures

Figure 1.
Figure 1.
Distribution of height SDS by period of reaching adulthood (n=1612). SDS, SD score.
Figure 2.
Figure 2.
Changes in final height SD score (SDS) over time according to age and period of start of renal replacement therapy (RRT) (n=981). The horizontal line in the middle of the box represents the median; the bottom and top of the box represent the lower and upper quartiles, respectively; and the ends of the whiskers represent the 10th and the 90th percentiles.
Figure 3.
Figure 3.
Mean yearly change in height SD score (SDS) from start of renal replacement therapy (RRT) to final height measurement by period of start of RRT (n=458). In patients who started RRT at age <16 years, the change in height SDS between start of RRT and final height SDS significantly improved (P=0.02). Analyses were adjusted for age at start of RRT.
See this image and copyright information in PMC

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