Andre J L, de Bernardin J M, Martinet N, Deschamps J P, Pierson M
Service de pédiatrie I, Hôpital d'Enfants, Vandoeuvre-lés-Nancy, France.
Pediatrie. 1989;44(6):495-504.
Fifty-nine children with end stage renal disease treated by hemodialysis or renal transplantation have been assessed for linear growth. Mean follow-up duration of study was 6 years (0.25 to 15.5 yr). At the beginning of hemodialysis, the mean growth delay was 2 SD. Every year, prepubertal children were affected by a growth delay of 0.50 SD whereas pubertal children caught up by +0.10 SD. In patients with renal transplantation, the mean growth curve remained at the same standard deviation once the transplant had been performed. An increase in growth was exhibited in about one-third of this group provided the transplant functioned satisfactorily and the patient was under 11 years of age. The characteristic pubertal linear growth spurt was delayed and demonstrated a lower amplitude than in normal children; but if it took place over a prolonged period, a better final height was obtained. The mean final stature was about 2 SD. There was strong variability in the final height according to the age of renal failure onset, renal transplantation and the level of renal function. Bone age allowed adult height to be predicted. Metabolic disorders have to be dealth with as soon as possible in order to limit growth impairment.
对59名接受血液透析或肾移植治疗的终末期肾病儿童的线性生长情况进行了评估。研究的平均随访时间为6年（0.25至15.5年）。在血液透析开始时，平均生长延迟为2个标准差。每年，青春期前儿童的生长延迟为0.50个标准差，而青春期儿童的生长追赶为+0.10个标准差。在肾移植患者中，移植手术后平均生长曲线保持在相同的标准差水平。如果移植功能良好且患者年龄在11岁以下，该组中约三分之一的患者生长会有所增加。青春期特有的线性生长突增延迟，且幅度低于正常儿童；但如果生长突增持续较长时间，则最终身高会更好。平均最终身高约为2个标准差。根据肾衰竭发病年龄、肾移植情况和肾功能水平，最终身高存在很大差异。骨龄可以预测成人身高。必须尽快处理代谢紊乱，以限制生长受损。
