PDF(Pubmed)
Abstract：
UNASSIGNED: Growth failure is considered the most important clinical outcome parameter in childhood chronic kidney disease (CKD). Central to the pathophysiology of growth failure is the presence of a chronic proinflammatory state, presumed to be partly driven by the accumulation of uremic toxins. In this study, we assessed the association between uremic toxin concentrations and height velocity in a longitudinal multicentric prospective pediatric CKD cohort of (pre)school-aged children and children during pubertal stages.
UNASSIGNED: In a prospective, multicentric observational study, a selection of uremic toxin levels of children (aged 0-18 years) with CKD stage 1 to 5D was assessed every 3 months (maximum 2 years) along with clinical growth parameters. Linear mixed models with a random slope for age and a random intercept for child were fitted for height (in cm and SD scores [SDS]). A piecewise linear association between age and height was assumed.
UNASSIGNED: Data analysis included data from 560 visits of 81 children (median age 9.4 years; 2/3 male). In (pre)school aged children (aged 2-12 years), a 10% increase in concurrent indoxyl sulfate (IxS, total) concentration resulted in an estimated mean height velocity decrease of 0.002 SDS/yr (P < 0.05), given that CKD stage, growth hormone (GH), bicarbonate concentration, and dietary protein intake were held constant. No significant association with height velocity was found in children during pubertal stages (aged >12 years).
UNASSIGNED: The present study demonstrated that, especially IxS contributes to a lower height velocity in (pre)school children, whereas we could not find a role for uremic toxins with height velocity during pubertal stages.
UNASSIGNED: In a prospective, multicentric observational study, a selection of uremic toxin levels of children (aged 0-18 years) with CKD stage 1 to 5D was assessed every 3 months (maximum 2 years) along with clinical growth parameters. Linear mixed models with a random slope for age and a random intercept for child were fitted for height (in cm and SD scores [SDS]). A piecewise linear association between age and height was assumed.
UNASSIGNED: Data analysis included data from 560 visits of 81 children (median age 9.4 years; 2/3 male). In (pre)school aged children (aged 2-12 years), a 10% increase in concurrent indoxyl sulfate (IxS, total) concentration resulted in an estimated mean height velocity decrease of 0.002 SDS/yr (P < 0.05), given that CKD stage, growth hormone (GH), bicarbonate concentration, and dietary protein intake were held constant. No significant association with height velocity was found in children during pubertal stages (aged >12 years).
UNASSIGNED: The present study demonstrated that, especially IxS contributes to a lower height velocity in (pre)school children, whereas we could not find a role for uremic toxins with height velocity during pubertal stages.
摘要：
■生长衰竭被认为是儿童慢性肾脏病（CKD）最重要的临床结果参数。生长障碍的病理生理学的核心是慢性促炎状态的存在，推测部分是由尿毒症毒素的积累驱动的。在这项研究中,我们在(学前)学龄儿童和青春期儿童的纵向多中心前瞻性儿科CKD队列中评估了尿毒症毒素浓度与身高速度之间的关联.
■在未来，多中心观察研究，我们每3个月(最长2年)对CKD1~5D期儿童(0~18岁)的尿毒症毒素水平以及临床生长参数进行了选择评估.对于身高（cm和SD评分[SDS]），拟合了具有年龄随机斜率和儿童随机截距的线性混合模型。假设年龄和身高之间存在分段线性关联。
数据分析包括81名儿童（平均年龄9.4岁；2/3男性）的560次访视数据。（学前）儿童（2-12岁），并发硫酸吲哚酚增加10%(IXS，总）浓度导致估计的平均高度速度降低0.002SDS/yr（P<0.05），考虑到CKD阶段，生长激素（GH），碳酸氢盐浓度,和膳食蛋白质摄入量保持恒定。在青春期（年龄>12岁）的儿童中，没有发现与身高速度的显着关联。
■本研究表明，尤其是IxS有助于降低（学前）儿童的身高速度，而在青春期阶段，我们找不到尿毒症毒素对身高速度的作用。
■在未来，多中心观察研究，我们每3个月(最长2年)对CKD1~5D期儿童(0~18岁)的尿毒症毒素水平以及临床生长参数进行了选择评估.对于身高（cm和SD评分[SDS]），拟合了具有年龄随机斜率和儿童随机截距的线性混合模型。假设年龄和身高之间存在分段线性关联。
数据分析包括81名儿童（平均年龄9.4岁；2/3男性）的560次访视数据。（学前）儿童（2-12岁），并发硫酸吲哚酚增加10%(IXS，总）浓度导致估计的平均高度速度降低0.002SDS/yr（P<0.05），考虑到CKD阶段，生长激素（GH），碳酸氢盐浓度,和膳食蛋白质摄入量保持恒定。在青春期（年龄>12岁）的儿童中，没有发现与身高速度的显着关联。
■本研究表明，尤其是IxS有助于降低（学前）儿童的身高速度，而在青春期阶段，我们找不到尿毒症毒素对身高速度的作用。
