Yuko Hamasaki1, Kenji Ishikura2,3, Osamu Uemura4, Shuichi Ito5, Naohiro Wada6, Motoshi Hattori7, Yasuo Ohashi8, Ryojiro Tanaka9, Koichi Nakanishi10, Tetsuji Kaneko3, Masataka Honda2. 1. Department of Pediatric Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. yuhamasaki@med.toho-u.ac.jp. 2. Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 3. Division of Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. 4. Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Aichi, Japan. 5. Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan. 6. Department of Pediatric Nephrology, Shizuoka Children's Hospital, Shizuoka, Japan. 7. Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan. 8. Department of Integrated Science and Technology for Sustainable Society, Chuo University, Tokyo, Japan. 9. Department of Nephrology, Hyogo Prefectural Children's Hospital, Hyogo, Japan. 10. Department of Pediatrics, Wakayama Medical University, Wakayama, Japan.
Abstract
BACKGROUND: Growth impairment is a major complication of chronic kidney disease (CKD) in children. However, no cohort studies have examined the growth of Asian children with pre-dialysis CKD. METHODS: We sent cross-sectional surveys to 113 Japanese medical institutions that were treating 447 children with CKD stages 3-5 in 2010 and 2011. Of 447 children included in our survey conducted in 2010, height and CKD stage were evaluable for 297 children in 2011, and height standard deviation score (height SDS) was calculated in these children. RESULTS: Height SDS decreased with increasing CKD stage (P < 0.001) in boys and girls. Height SDS also decreased significantly with increasing CKD stage among patients with congenital anomalies of the kidney and urinary tract (P < 0.001). Risk factors for growth impairment included CKD stages 4 and 5 (relative to stage 3), being small-for-date, and asphyxia at birth. Among children with a height SDS ≤-2.0, growth hormone was used in 19.5, 31.0, and 25.0 % of children with CKD stages 3, 4, and 5, respectively. CONCLUSIONS: This prospective cohort study revealed marked growth impairment in Japanese children with CKD stages 3-5 relative to healthy children. CKD-related risk factors for growth impairment included advanced CKD (stages 4 and 5), being small-for-date, and asphyxia at birth. Growth hormone was infrequently used in this cohort of children with pre-dialysis CKD.
BACKGROUND:Growth impairment is a major complication of chronic kidney disease (CKD) in children. However, no cohort studies have examined the growth of Asian children with pre-dialysis CKD. METHODS: We sent cross-sectional surveys to 113 Japanese medical institutions that were treating 447 children with CKD stages 3-5 in 2010 and 2011. Of 447 children included in our survey conducted in 2010, height and CKD stage were evaluable for 297 children in 2011, and height standard deviation score (height SDS) was calculated in these children. RESULTS: Height SDS decreased with increasing CKD stage (P < 0.001) in boys and girls. Height SDS also decreased significantly with increasing CKD stage among patients with congenital anomalies of the kidney and urinary tract (P < 0.001). Risk factors for growth impairment included CKD stages 4 and 5 (relative to stage 3), being small-for-date, and asphyxia at birth. Among children with a height SDS ≤-2.0, growth hormone was used in 19.5, 31.0, and 25.0 % of children with CKD stages 3, 4, and 5, respectively. CONCLUSIONS: This prospective cohort study revealed marked growth impairment in Japanese children with CKD stages 3-5 relative to healthy children. CKD-related risk factors for growth impairment included advanced CKD (stages 4 and 5), being small-for-date, and asphyxia at birth. Growth hormone was infrequently used in this cohort of children with pre-dialysis CKD.
Entities:
Keywords:
Child; Chronic kidney disease; Growth; Growth hormone; Japan
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