Growth impairment in children with pre-dialysis chronic kidney disease in Japan

• Published in: Clinical and experimental nephrology Vol. 19; no. 6; pp. 1142 - 1148
• Main Authors: Hamasaki, Yuko, Ishikura, Kenji, Uemura, Osamu, Ito, Shuichi, Wada, Naohiro, Hattori, Motoshi, Ohashi, Yasuo, Tanaka, Ryojiro, Nakanishi, Koichi, Kaneko, Tetsuji, Honda, Masataka
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.12.2015; Springer Nature B.V
• Subjects: Asphyxia Neonatorum - complications; Body Height; Child; Cohort Studies; Cross-Sectional Studies; Disease Progression; Female; Glomerular Filtration Rate; Growth Disorders - epidemiology; Growth Disorders - etiology; Health Surveys; Humans; Infant, Newborn; Japan - epidemiology; Male; Medicine; Medicine & Public Health; Nephrology; Original Article; Prospective Studies; Renal Dialysis; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - epidemiology; Risk Factors; Urology; Japan; Chronic kidney disease; Growth hormone; Growth; Child; Japan
• ISSN: 1342-1751; 1437-7799
• DOI: 10.1007/s10157-015-1098-y

Background Growth impairment is a major complication of chronic kidney disease (CKD) in children. However, no cohort studies have examined the growth of Asian children with pre-dialysis CKD. Methods We sent cross-sectional surveys to 113 Japanese medical institutions that were treating 447 children with CKD stages 3–5 in 2010 and 2011. Of 447 children included in our survey conducted in 2010, height and CKD stage were evaluable for 297 children in 2011, and height standard deviation score (height SDS) was calculated in these children. Results Height SDS decreased with increasing CKD stage ( P  < 0.001) in boys and girls. Height SDS also decreased significantly with increasing CKD stage among patients with congenital anomalies of the kidney and urinary tract ( P  < 0.001). Risk factors for growth impairment included CKD stages 4 and 5 (relative to stage 3), being small-for-date, and asphyxia at birth. Among children with a height SDS ≤−2.0, growth hormone was used in 19.5, 31.0, and 25.0 % of children with CKD stages 3, 4, and 5, respectively. Conclusions This prospective cohort study revealed marked growth impairment in Japanese children with CKD stages 3–5 relative to healthy children. CKD-related risk factors for growth impairment included advanced CKD (stages 4 and 5), being small-for-date, and asphyxia at birth. Growth hormone was infrequently used in this cohort of children with pre-dialysis CKD.