Early age-dependent growth impairment in chronic renal failure

Johan Karlberg, Franz Schaefer, Mascha Hennicke, Anne Margret Wingen, Sue Rigden, Otto Mehls, I. Rätch, K. Michelis, T. Kapogiannis, F. Jung, T. Lennert, S. Gellert, T. Tulassay, P. Sallay, T. Von Lilien, D. Michalk, M. A. Von Wendt-Göknur, K. E. Bonzel, R. Gusmano, E. VerrinaG. Offner, O. Mehls, A. M. Wingen, C. Fabian-Bach, A. Appiani, A. Bettinelli, J. Feber, G. Rizzoni, S. Picca, H. J. Stolpe, M. Wigger, J. Kist-van Holthe, E. Wolff, U. Berg, M. Fischbach, E. Dobos, E. Balzar, T. Neuhaus

Research output: Contribution to journalArticle

Abstract

We report early linear growth in 73 children (51 boys, 22 girls) with early onset of chronic renal failure (CRF). The inclusion criteria was onset of CRF before 6 months of age, two or more height measurements during the 1st year of life, follow-up for at least 3 years and continuously impaired renal function with a glomerular filtration rate below 50 ml/min per 1.73 m2 at 1 year or later. Only height measurements taken during conservative treatment or dialysis were included. The data were analysed in terms of the infancy-childhood-puberty growth model. There was an age-dependent growth failure in early life leading to an attained height of -3 standard deviation score (SDS) at 3 years of age. Approximately one-third of the reduction in height occurred during fetal life and one-third during the first postnatal months. Between 0.75 and 1.5 years of age height also decreased by 1 SD as a consequence of a delayed onset of the second, the 'childhood', phase of growth in 36% of the patients and by an 'offset childhood' growth pattern - i.e. a return to the infancy phase pattern after onset of the childhood phase - in 60% of the patients. Growth between 0.25-0.75 and 1.5-5 years of age was generally percentile parallel and thus less likely to be affected in CRF with early disease onset. The glomerular filtration rate was not related to the height gain in early life. We speculate that the growth failure during fetal life and the first postnatal months reflects metabolic and/or nutritional influences and the impaired growth at 0.75-1.5 years of age is related to a partial insensitivity to growth hormone.

Original languageEnglish
Pages (from-to)283-287
Number of pages5
JournalPediatric Nephrology
Volume10
Issue number3
DOIs
Publication statusPublished - Jun 1996

Keywords

  • Chronic renal failure
  • Growth hormone insensitivity
  • Height
  • Kidney disease
  • Longitudinal growth

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

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    Karlberg, J., Schaefer, F., Hennicke, M., Wingen, A. M., Rigden, S., Mehls, O., Rätch, I., Michelis, K., Kapogiannis, T., Jung, F., Lennert, T., Gellert, S., Tulassay, T., Sallay, P., Von Lilien, T., Michalk, D., Von Wendt-Göknur, M. A., Bonzel, K. E., Gusmano, R., ... Neuhaus, T. (1996). Early age-dependent growth impairment in chronic renal failure. Pediatric Nephrology, 10(3), 283-287. https://doi.org/10.1007/s004670050110