Seikaly Mouin G, Salhab Nina, Gipson Debbie, Yiu Verna, Stablein Donald
Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Pediatr Nephrol. 2006 Jun;21(6):793-9. doi: 10.1007/s00467-006-0040-7. Epub 2006 Apr 1.
Despite recent advances in the management of children with chronic kidney disease (CKD), growth remains suboptimal. The purpose of this study was to evaluate factors associated with short stature in children with CKD. We evaluated the chronic renal failure registry of the North American Pediatric Renal Transplant Cooperative Studies (NAPRTCS) to determine the relations among primary diagnosis, age, race, residual renal function, acidosis, anemia, serum phosphorous, calcium, parathyroid hormone (PTH), albumin, and height at entry into the registry in children with CKD. A total of 5,615 patients were entered into the registry between January 1994 and January 2004. We found that older patients, those with glomerular filtration rate (GFR) >50 ml min(-1) 1.73 m(-2), black patients and patients with focal segmental glomerulosclerosis (FSGS) were at lower risk of being short at entry. Anemia (hematocrit below 33%) was an independent risk factor for short stature. Acidosis, serum phosphorous, calcium, albumin and PTH at registration were poor predictors of short stature. Age, race, primary diagnosis, and residual renal function were associated with short stature in children with CKD.
尽管近年来在慢性肾脏病(CKD)患儿的管理方面取得了进展,但生长情况仍不尽人意。本研究的目的是评估与CKD患儿身材矮小相关的因素。我们评估了北美儿科肾移植协作研究(NAPRTCS)的慢性肾衰竭登记处,以确定CKD患儿在登记时的初始诊断、年龄、种族、残余肾功能、酸中毒、贫血、血清磷、钙、甲状旁腺激素(PTH)、白蛋白和身高之间的关系。1994年1月至2004年1月期间,共有5615例患者登记入册。我们发现,年龄较大的患者、肾小球滤过率(GFR)>50 ml·min⁻¹·1.73 m⁻²的患者、黑人患者以及局灶节段性肾小球硬化(FSGS)患者在登记时身材矮小的风险较低。贫血(血细胞比容低于33%)是身材矮小的独立危险因素。登记时的酸中毒、血清磷、钙、白蛋白和PTH对身材矮小的预测效果不佳。年龄、种族、初始诊断和残余肾功能与CKD患儿的身材矮小有关。