PDF(Pubmed)
Abstract：
BACKGROUND: Growth failure in chronic kidney disease is related to high morbidity and mortality. Growth retardation in this disease is multifactorial. Knowing the modifiable factors and establishing strategies to improve care for affected children is paramount.
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.
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.
摘要：
背景：慢性肾脏病的生长衰竭与高发病率和高死亡率有关。这种疾病的生长迟缓是多因素的。了解可改变的因素并制定改善受影响儿童护理的策略至关重要。
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。
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。
