Prediction of adult height in children with chronic renal insufficiency

Abstract

The ability to accurately predict adult height (AH) has important implications for the management of children with chronic renal insufficiency (CRI). Serial predictions of AH were performed for 22 pediatric patients with CRI of variable duration and severity using the Tanner predictive method. The patients were followed until completion of growth. At the first predictions, the prediction error (PE) was within an acceptable range of +/- 2 cm in 59% of the patients. The mean size of the PE was 2.7 cm. It was larger in 7 patients with a bone age up to 11 years (4.9 cm) as compared to 15 patients with more advanced bone age (1.7 cm) and also larger in males (3.4 cm) than in females (2.4 cm). There was no correlation between size or direction of PE and (1) mode of treatment and (2) time elapsed between the first prediction and age at AH. A significant association was found between the direction of PE and the relative change in body height from the first prediction to adult age. Patients with decreasing SD scores were overpredicted and those with increasing SD scores were underpredicted at the initial assessment. Serial predictions gave large variations only in 2 girls who presented with unusual growth patterns. These results indicate that the method applied allows a reliable prognosis of future growth in most children with CRI.