Adult Height in Patients with Advanced CKD Requiring Renal Replacement Therapy during Childhood

作者：Harambat Jerome; Bonthuis Marjolein; van Stralen Karlijn J^*; Ariceta Gema; Battelino Nina; Bjerre Anna; Jahnukainen Timo; Leroy Valerie; Reusz Gyoergy; Sandes Ana R; Sinha Manish D; Groothoff Jaap W; Combe Christian; Jager Kitty J; Verrina Enrico; Schaefer Franz

来源：Clinical Journal of the American Society of Nephrology, 2014, 9(1): 92-99.

DOI：10.2215/CJN.00890113

Background and objectivesGrowth 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, & measurementsA 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.ResultsThe 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.ConclusionsAlthough final height remains suboptimal in children with ESRD, it has consistently improved over time.

• 出版日期2014-1-7