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

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.

[1]  A. Edefonti,et al.  Use of National and International Growth Charts for Studying Height in European Children: Development of Up-To-Date European Height-For-Age Charts , 2012, PloS one.

[2]  J. Bacchetta,et al.  The consequences of chronic kidney disease on bone metabolism and growth in children. , 2012, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[3]  A. Edefonti,et al.  Growth in very young children undergoing chronic peritoneal dialysis. , 2011, Journal of the American Society of Nephrology : JASN.

[4]  T. Seeman,et al.  Demographics of blood pressure and hypertension in children on renal replacement therapy in Europe. , 2011, Kidney international.

[5]  R. Mak,et al.  Nutrition and growth in children with chronic kidney disease , 2011, Nature Reviews Nephrology.

[6]  K. Jahnukainen,et al.  Pubertal Development is Normal in Adolescents After Renal Transplantation in Childhood , 2011, Transplantation.

[7]  A. Jankauskienė,et al.  Determinants of eGFR at start of renal replacement therapy in paediatric patients. , 2010, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[8]  D. Mekahli,et al.  Long-term outcome of infants with severe chronic kidney disease. , 2010, Clinical journal of the American Society of Nephrology : CJASN.

[9]  P. Cochat,et al.  Growth after renal transplantation , 2009, Pediatric Nephrology.

[10]  D. Moster,et al.  [Growth references for Norwegian children]. , 2009, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.

[11]  A. Lezcano,et al.  Estudio transversal español de crecimiento 2008. Parte II: valores de talla, peso e índice de masa corporal desde el nacimiento a la talla adulta , 2008 .

[12]  D. Haffner,et al.  Factors predicting the near-final height in growth hormone-treated children and adolescents with chronic kidney disease. , 2008, The Journal of clinical endocrinology and metabolism.

[13]  F. Dekker,et al.  Confounding: what it is and how to deal with it. , 2008, Kidney international.

[14]  J. López-Siguero,et al.  [Spanish cross-sectional growth study 2008. Part II. Height, weight and body mass index values from birth to adulthood]. , 2008, Anales de pediatria.

[15]  E. Spada,et al.  Italian cross-sectional growth charts for height, weight and BMI (2 to 20 yr) , 2006, Journal of endocrinological investigation.

[16]  F. Schaefer,et al.  Psychosocial rehabilitation and satisfaction with life in adults with childhood-onset of end-stage renal disease , 2005, Pediatric Nephrology.

[17]  J. Tutkuviene.  Body size indices for growth monitoring of Lithuanian children and adolescents: comparative study of height , 2005 .

[18]  J. Vignerová,et al.  The 6th nationwide anthropological survey of children and adolescents in the Czech Republic in 2001. , 2004, Central European journal of public health.

[19]  D. Haffner,et al.  Effect of renal transplantation in childhood on longitudinal growth and adult height. , 2004, Kidney international.

[20]  P. Niaudet,et al.  LONG-TERM SOCIAL OUTCOME OF CHILDREN AFTER KIDNEY TRANSPLANTATION , 2004, Transplantation.

[21]  Ethan M Balk,et al.  Short stature and functional impairment: a systematic review. , 2004, Archives of pediatrics & adolescent medicine.

[22]  U. Berg,et al.  Growth impairment at renal transplantation – A determinant of growth and final height , 2003, Pediatric transplantation.

[23]  C. Jones,et al.  Factors influencing growth and final height after renal transplantation , 2002, Pediatric transplantation.

[24]  N. Powe,et al.  Growth failure, risk of hospitalization and death for children with end-stage renal disease , 2002, Pediatric Nephrology.

[25]  J. Flynn,et al.  Improved growth in young children with severe chronic renal insufficiency who use specified nutritional therapy. , 2001, Journal of the American Society of Nephrology.

[26]  C. Loris,et al.  Predictors of Final Adult Height after Renal Transplantation during Childhood: A Single-Center Study , 2000, Nephron.

[27]  B. Tönshoff,et al.  Effect of growth hormone treatment on the adult height of children with chronic renal failure , 2000 .

[28]  Stef van Buuren,et al.  Continuing Positive Secular Growth Change in the Netherlands 1955–1997 , 2000, Pediatric Research.

[29]  F. Schaefer,et al.  Peritoneal transport properties and dialysis dose affect growth and nutritional status in children on chronic peritoneal dialysis. Mid-European Pediatric Peritoneal Dialysis Study Group. , 1999, Journal of the American Society of Nephrology : JASN.

[30]  J. Ehrich,et al.  Kidney transplanted children come of age. , 1999, Kidney international.

[31]  T. Stijnen,et al.  Final Height and Its Predictive Factors after Renal Transplantation in Childhood , 1994, Pediatric Research.

[32]  K. Schärer,et al.  Alterations in growth hormone secretion and clearance in peripubertal boys with chronic renal failure and after renal transplantation. Cooperative Study Group of Pubertal development in Chronic Renal Failure. , 1994, The Journal of clinical endocrinology and metabolism.

[33]  J. Ehrich,et al.  Combined report on regular dialysis and transplantation of children in Europe, 1990. , 1991, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[34]  T. Gasser,et al.  Pubertal Growth in Chronic Renal Failure , 1990, Pediatric Research.

[35]  O. Salvatierra,et al.  Twenty years of renal transplantation in children. , 1986, Pediatrics.

[36]  E. Balas,et al.  Combined report on regular dialysis and transplantation of children in Europe, XIII, 1983. , 1985, Proceedings of the European Dialysis and Transplant Association - European Renal Association. European Dialysis and Transplant Association - European Renal Association. Congress.