Growth in children on kidney replacement therapy: a review of data from patient registries

Abstract

Growth retardation is a major complication in children with chronic kidney disease (CKD) and on kidney replacement therapy (KRT). Conversely, better growth in childhood CKD is associated with an improvement in several hard morbidity-mortality endpoints. Data from pediatric international registries has demonstrated that improvements in the overall conservative management of CKD, the search for optimal dialysis, and advances in immunosuppression and kidney transplant techniques have led to a significant improvement of final height over time. Infancy still remains a critical period for adequate linear growth, and the loss of stature during the first years of life influences final height. Preliminary new original data from the European Society for Paediatric Nephrology/European Renal Association-European Dialysis and Transplant Association (ESPN/ERA-EDTA) Registry confirm an association between the final height and the height attained at 2 years in children on KRT.

Keywords: Children; Chronic kidney disease; Dialysis; Final height; Growth; Kidney replacement therapy; Transplant.

Fig. 1

Unadjusted post-transplant growth patterns stratified by age at kidney transplantation. (Reproduced with minor revision from [25], used with permission)

Fig. 2

Final height standard deviation scores (SDS) by height SDS at the age of 2 years among 101 patients on kidney replacement therapy (KRT) from the ESPN/ERA-EDTA Registry. The solid line depicts the linear regression analysis adjusted for age and period of KRT, sex, and cause of kidney failure