title: Growth impairment in children with pre-dialysis chronic kidney disease in Japan.
abstract: 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.
authors.affiliation: Department of Pediatric Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan. yuhamasaki@med.toho-u.ac.jp.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hamasaki
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.|Division of Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishikura
authors.affiliation: Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Aichi, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Uemura
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Pediatric Nephrology, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Wada
authors.affiliation: Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Hattori
authors.affiliation: Department of Integrated Science and Technology for Sustainable Society, Chuo University, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Department of Nephrology, Hyogo Prefectural Children's Hospital, Hyogo, Japan.
authors.forename: Ryojiro
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Wakayama Medical University, Wakayama, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakanishi
authors.affiliation: Division of Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications; D001827:Body Height; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006130:Growth Disorders / Q000453:epidemiology / Q000209:etiology*; D006306:Health Surveys; D006801:Humans; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors
keywords: Child; Chronic kidney disease; Growth; Growth hormone; Japan