Eujin Park1, Hye Jin Lee1, Hyun Jin Choi2, Yo Han Ahn2,3,4, Kyoung Hee Han5, Seong Heon Kim2,6, Heeyeon Cho7, Jae Il Shin8,9, Joo Hoon Lee10, Young Seo Park10, Il-Soo Ha2,3,4, Min Hyun Cho11, Hee Gyung Kang12,13,14,15. 1. Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea. 2. Department of Pediatrics, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. 3. Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea. 4. Kidney Research Institute, Seoul National University Medical Research Center, Seoul, South Korea. 5. Department of Pediatrics, Jeju National University, College of Medicine and Graduate School of Medicine, Jeju, South Korea. 6. Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, South Korea. 7. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. 8. Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea. 9. Division of Pediatric Nephrology, Severance Children's Hospital, Seoul, South Korea. 10. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 11. Department of Pediatrics, Kyungpook National University, School of Medicine, 130 Dongdeok-ro,Jung-gu, Daegu, 41944, South Korea. chomh@knu.ac.kr. 12. Department of Pediatrics, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. kanghg@snu.ac.kr. 13. Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea. kanghg@snu.ac.kr. 14. Kidney Research Institute, Seoul National University Medical Research Center, Seoul, South Korea. kanghg@snu.ac.kr. 15. Wide River Institute of Immunology, Seoul National University, Hongcheon, South Korea. kanghg@snu.ac.kr.
Abstract
BACKGROUND: Preserving optimal growth has long been a significant concern for children with chronic kidney disease (CKD). We aimed to examine the incidence of and risk factors for short stature in Asian pediatric patients with CKD. METHODS: We analyzed growth status by height, weight, and body mass index (BMI) standard deviation scores (SDSs) for 432 participants in the KoreaN cohort study for Outcome in patients With Pediatric Chronic Kidney Disease. RESULTS: The median height, weight, and BMI SDSs were - 0.94 (interquartile range (IQR) - 1.95 to 0.05), - 0.58 (IQR - 1.46 to 0.48), and - 0.26 (IQR - 1.13 to 0.61), respectively. A high prevalence of short stature (101 of 432 patients, 23.4%) and underweight (61 of 432 patients, 14.1%) was observed. In multivariable logistic regression analysis, CKD stages 4 and 5 (adjusted odds ratio (aOR) 2.700, p = 0.001), onset before age 2 (aOR 2.928, p < 0.0001), underweight (aOR 2.353, p = 0.013), premature birth (aOR 3.484, p < 0.0001), LBW (aOR 3.496, p = 0.001), and low household income (aOR 1.935, p = 0.030) were independent risk factors associated with short stature in children with CKD. CONCLUSIONS: Children with CKD in Korea were shorter and had lower body weight and BMI than the general population. Short stature in children with CKD was most independently associated with low birth weight, followed by premature birth, onset before age 2, CKD stages 4 and 5, underweight, and low household income. Among these, underweight is the only modifiable factor. Therefore, we suggest children with CKD should be carefully monitored for weight, nutritional status, and body composition to achieve optimal growth.
BACKGROUND: Preserving optimal growth has long been a significant concern for children with chronic kidney disease (CKD). We aimed to examine the incidence of and risk factors for short stature in Asian pediatric patients with CKD. METHODS: We analyzed growth status by height, weight, and body mass index (BMI) standard deviation scores (SDSs) for 432 participants in the KoreaN cohort study for Outcome in patients With Pediatric Chronic Kidney Disease. RESULTS: The median height, weight, and BMI SDSs were - 0.94 (interquartile range (IQR) - 1.95 to 0.05), - 0.58 (IQR - 1.46 to 0.48), and - 0.26 (IQR - 1.13 to 0.61), respectively. A high prevalence of short stature (101 of 432 patients, 23.4%) and underweight (61 of 432 patients, 14.1%) was observed. In multivariable logistic regression analysis, CKD stages 4 and 5 (adjusted odds ratio (aOR) 2.700, p = 0.001), onset before age 2 (aOR 2.928, p < 0.0001), underweight (aOR 2.353, p = 0.013), premature birth (aOR 3.484, p < 0.0001), LBW (aOR 3.496, p = 0.001), and low household income (aOR 1.935, p = 0.030) were independent risk factors associated with short stature in children with CKD. CONCLUSIONS: Children with CKD in Korea were shorter and had lower body weight and BMI than the general population. Short stature in children with CKD was most independently associated with low birth weight, followed by premature birth, onset before age 2, CKD stages 4 and 5, underweight, and low household income. Among these, underweight is the only modifiable factor. Therefore, we suggest children with CKD should be carefully monitored for weight, nutritional status, and body composition to achieve optimal growth.
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