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Growth impairment shows an age-dependent pattern in boys with chronic kidney disease

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Abstract

The impact of chronological age on longitudinal body growth from early childhood through adolescence using detailed anthropometric methods has not yet been studied in children with chronic kidney disease (CKD). We have evaluated growth failure by measuring four components of linear growth: body height (HT), sitting height (SHT), arm length (AL) and leg length (LL). Data were prospectively collected for up to 7 years on 190 boys (3–21 years old) with congenital or hereditary CKD (all had developed at least stage 2 CKD by the age of 10 years). Patients showed the most severe growth failure in early childhood, followed by an acceleration in growth in pre-puberty, a slowing-down of growth at puberty, as expected, and thereafter a late speeding-up of growth until early adulthood. This pattern was observed irrespective of the degree of CKD and different treatment modalities, such as conservative treatment, recombinant human growth hormone (rhGH) therapy or transplantation. LL showed the most dynamic growth changes of all the parameters evaluated and emerged as the best indicator of statural growth in children with CKD. A specific age-dependent pattern of physical growth was identified in pediatric male CKD patients. This growth pattern should be considered in the evaluation of individual growth and the assessment of treatment efficacy such as rhGH therapy.

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Acknowledgements

We thank all patients and their families for their cooperation. We are indebted to the doctors and nurses in Hannover and Berlin for their help and to Darlene Poulin for her valuable editing of the English language. This study was supported by an institutional grant from Pfizer, Karlsruhe, Germany and clinical research funds of the Charité University Hospital Berlin.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Children’s Hospital of Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Miroslav Živičnjak, Doris Franke, Kerstin Froede, Sanny Haase, Gisela Offner & Jochen H. H. Ehrich

  2. Department of Pediatrics, Division of Nephrology, Children’s Hospital of Eastern Ontario, 401 Smyth Road, K1H 8L1, Ottawa, ON, Canada

    Guido Filler

  3. Department of Pediatric Nephrology, Charité University Hospital, Augustenburger Platz 1, 13353, Berlin, Germany

    Dieter Haffner, Richard Nissel & Uwe Querfeld

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  1. Miroslav Živičnjak
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  2. Doris Franke
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  3. Guido Filler
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  6. Richard Nissel
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  9. Jochen H. H. Ehrich
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  10. Uwe Querfeld
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Correspondence to Miroslav Živičnjak.

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Živičnjak, M., Franke, D., Filler, G. et al. Growth impairment shows an age-dependent pattern in boys with chronic kidney disease. Pediatr Nephrol 22, 420–429 (2007). https://doi.org/10.1007/s00467-006-0345-6

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  • DOI: https://doi.org/10.1007/s00467-006-0345-6

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