title: Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children Study.
abstract: BACKGROUND
  Growth failure is common among children with chronic kidney disease (CKD). We examined the relationship of growth parameters with glomerular filtration rate (GFR), CKD diagnosis, sex and laboratory results in children with CKD.
  
  
  METHODS
  Baseline data from 799 children (median age 11.0 years, median GFR 49.9 mL/min/1.73 m(2)) participating in the Chronic Kidney Disease in Children Study were examined. Growth was quantified by age-sex-specific height, weight, body mass index (BMI-age), and height-age-sex-specific BMI (BMI-height-age) standard deviation scores (SDS).
  
  
  RESULTS
  Median height and weight SDS were -0.55 [interquartile range (IQR) -1.35 to 0.19] and 0.03 (IQR -0.82 to 0.97), respectively. Girls with non-glomerular CKD were the shortest (median height SDS -0.83; IQR -1.62 to -0.02). Compared to those with a serum bicarbonate (CO2) level of ≥ 22 mEq/L, children with CO2 of <18 mEq/L had a height SDS that was on average 0.67 lower [95 % confidence interval (CI) -0.31 to -1.03]. Only 23 % of children with a height SDS of ≤-1.88 were prescribed growth hormone therapy. Forty-six percent of children with glomerular CKD were overweight or obese (BMI-height-age ≥ 85th percentile).
  
  
  CONCLUSIONS
  Growth outcomes in a contemporary cohort of children with CKD remain suboptimal. Interventions targeting metabolic acidosis and overcoming barriers to recombinant human growth hormone usage may improve growth in this population.
authors.affiliation: Division of Nephrology , Harvard Medical School-Children's Hospital Boston, Boston, MA, 02115, USA, nancy.rodig@childrens.harvard.edu.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Rodig
authors.forename: Kelly C
authors.initials: KC
authors.lastname: McDermott
authors.forename: Michael F
authors.initials: MF
authors.lastname: Schneider
authors.forename: Hilary M
authors.initials: HM
authors.lastname: Hotchkiss
authors.forename: Ora
authors.initials: O
authors.lastname: Yadin
authors.forename: Mouin G
authors.initials: MG
authors.lastname: Seikaly
authors.forename: Susan L
authors.initials: SL
authors.lastname: Furth
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Warady
mesh_terms: D000293:Adolescent; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D015331:Cohort Studies; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications*
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