Department of Pediatric Kidney, Liver and Metabolic Diseases, Children's Hospital, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
Pediatr Nephrol. 2013 Dec;28(12):2335-41. doi: 10.1007/s00467-013-2604-7. Epub 2013 Sep 1.
We analyzed the impact of birth parameters and parental height on long-term growth outcome in children with chronic kidney disease (CKD) stage 3-5.
Linear growth was prospectively investigated in 509 children, with a mean follow-up of 4.1 years. Growth outcome was categorized in (i) poor growth (PG): height standard deviation score (SDS) during follow-up < -2.0 and/or actual or previous growth hormone (GH) treatment, and (ii) good growth (GG): height SDS ≥ -2.0 and no need for GH. A multivariate binary logistic regression model was constructed for predictors of PG outcome.
PG was observed in 55 % of patients. The rate of pre-term and small for gestational age birth was significantly higher in children with PG compared to GG (43.2 vs. 25.6 % and 36.8 vs. 18.9 %; p < 0.001). Children with PG had significantly lower average values for gestational age, birth weight, length, and head circumference, umbilical cord pH, Apgar scores, and parental height than children with GG. Birth length, umbilical cord pH, and parental height were significant independent predictors of PG outcome (sensitivity 72.8 %, specificity 69.3 %).
Birth parameters and parental height are independent predictors of growth outcome in children with CKD.
我们分析了出生参数和父母身高对慢性肾脏病（CKD）3-5 期儿童长期生长结果的影响。
前瞻性研究了 509 名儿童的线性生长情况，平均随访时间为 4.1 年。生长结果分为（i）生长不良（PG）：随访期间身高标准差评分（SDS）<-2.0 和/或实际或先前生长激素（GH）治疗，和（ii）良好生长（GG）：身高 SDS≥-2.0 且无需 GH 治疗。建立了多变量二项逻辑回归模型，用于预测 PG 结局的指标。
55%的患者出现 PG。PG 组患儿的早产和小于胎龄儿的发生率明显高于 GG 组（43.2%比 25.6%和 36.8%比 18.9%；p<0.001）。PG 组患儿的平均胎龄、出生体重、身长和头围、脐带血 pH 值、阿普加评分和父母身高均明显低于 GG 组。出生身长、脐带血 pH 值和父母身高是 PG 结局的独立预测指标（敏感性 72.8%，特异性 69.3%）。
出生参数和父母身高是 CKD 儿童生长结果的独立预测指标。
