OBJECTIVE: To describe growth patterns in children with chronic kidney disease and the risk factors associated with short stature.
METHODS: We retrospectively analyzed anthropometric and epidemiological data, birth weight, prematurity, and bicarbonate, hemoglobin, calcium, phosphate, alkaline phosphatase, and parathormone levels of children with stages 3-5 CKD not on dialysis, followed for at least one year.
RESULTS: We included 43 children, the majority of which were boys (65%). The mean height/length /age z-score of the children at the beginning and follow-up was -1.89 ± 1.84 and -2.4 ± 1.67, respectively (p = 0.011). Fifty-one percent of the children had short stature, and these children were younger than those with adequate stature (p = 0.027). PTH levels at the beginning of the follow-up correlated with height/length/age z-score. A sub-analysis with children under five (n = 17) showed that 10 (58.8%) of them failed to thrive and had a lower weight/age z-score (0.031) and lower BMI/age z-score (p = 0.047).
CONCLUSIONS: Children, particularly younger ones, with chronic kidney disease who were not on dialysis had a high prevalence of short stature. PTH levels were correlated with height z-score, and growth failure was associated with worse nutritional status. Therefore, it is essential to monitor the growth of these children, control hyperparathyroidism, and provide nutritional support.
目的:描述慢性肾脏病患儿的生长模式和与身材矮小相关的危险因素。
方法:我们回顾性分析人体测量和流行病学资料,出生体重,早产,和碳酸氢盐,血红蛋白,钙,磷酸盐,碱性磷酸酶,未透析的3-5期CKD儿童的副激素水平,跟随至少一年。
结果:我们包括43名儿童,其中大多数是男孩(65%)。开始和随访时儿童的平均身高/身长/年龄z评分分别为-1.89±1.84和-2.4±1.67(p=0.011)。51%的孩子身材矮小,这些孩子比那些有足够身材的孩子年轻(p=0.027)。随访开始时的PTH水平与身高/身长/年龄z评分相关。对5岁以下儿童(n=17)的亚分析显示,其中10人(58.8%)未能茁壮成长,体重/年龄z评分较低(0.031)和BMI/年龄z评分较低(p=0.047)。
结论:儿童,尤其是年轻人,慢性肾脏病患者未进行透析时身材矮小的患病率较高。PTH水平与身高z评分相关,生长障碍与恶化的营养状况有关。因此,监测这些孩子的成长至关重要,控制甲状旁腺功能亢进,并提供营养支持。