Abstract
Objective: The aim of the study was to determine the effects of conservative treatment, continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis on height growth in pediatric chronic renal insufficiency (CRI) patients who have not yet received renal replacement treatment.
Material and Methods: This retrospective study included 87 pediatric CRI patients who were regularly followed for at least 6 months, and had not received growth hormone or renal replacement treatment. Patients were classified according to treatment modalities as predialysis (n=25), CAPD (n=47) and hemodialysis (n=15). Height, mean height standard deviation score (SDS) and mean Δ height SDS were used for anthropometric measurements. The data were evaluated at the beginning of the study and then at the first, second and third years of the longitudinal follow-up. As the decimal ages of the groups showed a statistically significant difference (p<0.01), comparison was conducted between the mean height SDS and Δ height SDS that deactivated the age factor. results: The mean height SDS and Δ height SDS did not differ between the groups in the first and third years. However, there was a statistically significant difference between predialysis and CAPD for the mean height SDS and Δ height SDS in the second year of the follow-up and these parameters were significantly higher in the predialysis group (p<0.05 and p<0.01). conclusion: Ensuring a normal growth pattern for pediatric CRI patients is an important problem. Early renal transplantation makes it possible for these children to attain a satisfying final adult height
Keywords: Height, Hemodialysis, Chronic renal insufficiency, CAPD
References
- Fine Rn. Etiology and treatment of growth retardation in children with chronic kidney disease and end-stage renal disease: A historical perspective. Pediatr nephrol 2010;25:725-32.
- Janjua HS, Mahan JD. Growth in chronic kidney disease. Adv Chronic Kidney Dis 2011;18:324-31.
- Issa n, lankireddy S, Kukla A. Should peritoneal dialysis be the preferred therapy pre-kidney transplantation? Adv Perit Dial 2012;28:89-93.
- Stefanidis l, Klaus G. Growth of pre-pubertal children on dialysis. Pediatr nephrol 2007;22:1251-9.
- Wesseling-Perry K, Salusky IB. Chronic kidney disease: Mineral and bone disorder in children. Semin nephrol 2013;33:169-79.
- Mahan JD, Warady BA. Assessment and treatment of short stature in pediatric patients with chronic kidney disease: A consensus statement. Pediatr nephrol 2006; 21:917-30.
- Kari JA, Gonzalez C, ledermann SE, Shaw V, Rees l. Outcome and growth of infants with severe chronic renal failure. Kidney Int 2000;57:1681-7.