Virgínia Barbosa de Melo, Danielle Barbosa da Silva, Matheus Dantas Soeiro, Lucas Cavalcante Tenório de Albuquerque, Henderson Edward Firmino Cavalcanti, Marcela Correa Araújo Pandolfi, Rosilene Mota Elias, Rosa Maria Affonso Moysés, Emília Maria Dantas Soeiro
{"title":"慢性肾脏病患儿的生长发育及导致身材矮小的相关风险因素。","authors":"Virgínia Barbosa de Melo, Danielle Barbosa da Silva, Matheus Dantas Soeiro, Lucas Cavalcante Tenório de Albuquerque, Henderson Edward Firmino Cavalcanti, Marcela Correa Araújo Pandolfi, Rosilene Mota Elias, Rosa Maria Affonso Moysés, Emília Maria Dantas Soeiro","doi":"10.1590/2175-8239-JBN-2023-0203en","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Growth failure in chronic kidney disease is related to high morbidity and mortality. Growth retardation in this disease is multifactorial. Knowing the modifiable factors and establishing strategies to improve care for affected children is paramount.</p><p><strong>Objectives: </strong>To describe growth patterns in children with chronic kidney disease and the risk factors associated with short stature.</p><p><strong>Methods: </strong>We retrospectively analyzed anthropometric and epidemiological data, birth weight, prematurity, and bicarbonate, hemoglobin, calcium, phosphate, alkaline phosphatase, and parathormone levels of children with stages 3-5 CKD not on dialysis, followed for at least one year.</p><p><strong>Results: </strong>We included 43 children, the majority of which were boys (65%). The mean height/length /age z-score of the children at the beginning and follow-up was -1.89 ± 1.84 and -2.4 ± 1.67, respectively (p = 0.011). Fifty-one percent of the children had short stature, and these children were younger than those with adequate stature (p = 0.027). PTH levels at the beginning of the follow-up correlated with height/length/age z-score. A sub-analysis with children under five (n = 17) showed that 10 (58.8%) of them failed to thrive and had a lower weight/age z-score (0.031) and lower BMI/age z-score (p = 0.047).</p><p><strong>Conclusion: </strong>Children, particularly younger ones, with chronic kidney disease who were not on dialysis had a high prevalence of short stature. PTH levels were correlated with height z-score, and growth failure was associated with worse nutritional status. Therefore, it is essential to monitor the growth of these children, control hyperparathyroidism, and provide nutritional support.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"46 4","pages":"e20230203"},"PeriodicalIF":1.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305564/pdf/","citationCount":"0","resultStr":"{\"title\":\"Growth in children with chronic kidney disease and associated risk factors for short stature.\",\"authors\":\"Virgínia Barbosa de Melo, Danielle Barbosa da Silva, Matheus Dantas Soeiro, Lucas Cavalcante Tenório de Albuquerque, Henderson Edward Firmino Cavalcanti, Marcela Correa Araújo Pandolfi, Rosilene Mota Elias, Rosa Maria Affonso Moysés, Emília Maria Dantas Soeiro\",\"doi\":\"10.1590/2175-8239-JBN-2023-0203en\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Growth failure in chronic kidney disease is related to high morbidity and mortality. Growth retardation in this disease is multifactorial. Knowing the modifiable factors and establishing strategies to improve care for affected children is paramount.</p><p><strong>Objectives: </strong>To describe growth patterns in children with chronic kidney disease and the risk factors associated with short stature.</p><p><strong>Methods: </strong>We retrospectively analyzed anthropometric and epidemiological data, birth weight, prematurity, and bicarbonate, hemoglobin, calcium, phosphate, alkaline phosphatase, and parathormone levels of children with stages 3-5 CKD not on dialysis, followed for at least one year.</p><p><strong>Results: </strong>We included 43 children, the majority of which were boys (65%). The mean height/length /age z-score of the children at the beginning and follow-up was -1.89 ± 1.84 and -2.4 ± 1.67, respectively (p = 0.011). Fifty-one percent of the children had short stature, and these children were younger than those with adequate stature (p = 0.027). PTH levels at the beginning of the follow-up correlated with height/length/age z-score. A sub-analysis with children under five (n = 17) showed that 10 (58.8%) of them failed to thrive and had a lower weight/age z-score (0.031) and lower BMI/age z-score (p = 0.047).</p><p><strong>Conclusion: </strong>Children, particularly younger ones, with chronic kidney disease who were not on dialysis had a high prevalence of short stature. PTH levels were correlated with height z-score, and growth failure was associated with worse nutritional status. Therefore, it is essential to monitor the growth of these children, control hyperparathyroidism, and provide nutritional support.</p>\",\"PeriodicalId\":14724,\"journal\":{\"name\":\"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia\",\"volume\":\"46 4\",\"pages\":\"e20230203\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11305564/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1590/2175-8239-JBN-2023-0203en\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/2175-8239-JBN-2023-0203en","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
导言:慢性肾脏病患者的生长迟缓与高发病率和高死亡率有关。这种疾病的生长迟缓是由多种因素造成的。了解可改变的因素并制定改善患儿护理的策略至关重要:描述慢性肾脏病患儿的生长模式以及与身材矮小相关的风险因素:我们回顾性分析了未接受透析的 3-5 期 CKD 患儿的人体测量和流行病学数据、出生体重、早产儿以及碳酸氢盐、血红蛋白、钙、磷酸盐、碱性磷酸酶和副激素水平,并对其进行了至少一年的随访:我们共纳入了 43 名儿童,其中大多数是男孩(65%)。儿童的平均身高/身长/年龄 Z 值分别为-1.89 ± 1.84 和 -2.4 ± 1.67(P = 0.011)。51%的儿童身材矮小,这些儿童的年龄小于身材正常的儿童(p = 0.027)。随访初期的 PTH 水平与身高/身长/年龄 Z 值相关。对五岁以下儿童(n = 17)进行的子分析表明,其中 10 名儿童(58.8%)未能茁壮成长,体重/年龄 Z 值(0.031)和体重指数/年龄 Z 值(p = 0.047)均较低:结论:未接受透析的慢性肾病患儿,尤其是年龄较小的患儿,身材矮小的发病率较高。PTH水平与身高Z值相关,而生长发育迟缓与营养状况较差有关。因此,必须监测这些儿童的生长情况,控制甲状旁腺功能亢进,并提供营养支持。
Growth in children with chronic kidney disease and associated risk factors for short stature.
Introduction: Growth failure in chronic kidney disease is related to high morbidity and mortality. Growth retardation in this disease is multifactorial. Knowing the modifiable factors and establishing strategies to improve care for affected children is paramount.
Objectives: To describe growth patterns in children with chronic kidney disease and the risk factors associated with short stature.
Methods: We retrospectively analyzed anthropometric and epidemiological data, birth weight, prematurity, and bicarbonate, hemoglobin, calcium, phosphate, alkaline phosphatase, and parathormone levels of children with stages 3-5 CKD not on dialysis, followed for at least one year.
Results: We included 43 children, the majority of which were boys (65%). The mean height/length /age z-score of the children at the beginning and follow-up was -1.89 ± 1.84 and -2.4 ± 1.67, respectively (p = 0.011). Fifty-one percent of the children had short stature, and these children were younger than those with adequate stature (p = 0.027). PTH levels at the beginning of the follow-up correlated with height/length/age z-score. A sub-analysis with children under five (n = 17) showed that 10 (58.8%) of them failed to thrive and had a lower weight/age z-score (0.031) and lower BMI/age z-score (p = 0.047).
Conclusion: Children, particularly younger ones, with chronic kidney disease who were not on dialysis had a high prevalence of short stature. PTH levels were correlated with height z-score, and growth failure was associated with worse nutritional status. Therefore, it is essential to monitor the growth of these children, control hyperparathyroidism, and provide nutritional support.