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Growth Hormone Disorders and Abnormal Stature in Kidney Disease

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Endocrine Disorders in Kidney Disease

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Abstract

Growth retardation is the most visible of all the comorbidities associated with the development of chronic kidney disease (CKD) in children. In addition to the cosmetic impact, poor growth has been associated with an impaired health-related quality of life and increased rates of morbidity and mortality. Factors which contribute to the development of this complication include inadequate nutrition, abnormal bone metabolism, salt depletion, cause and severity of the primary renal disorder, metabolic acidosis, delayed puberty, and abnormalities of the growth hormone/insulin-like growth factor I (GH/IGF-I) axis. Evaluation for and treatment of the modifiable risk factors are mandatory to enhance height velocity. Attention to nutritional deficiencies is most important during infancy and often requires enteral tube support to achieve nutritional targets. The use of recombinant human growth hormone (rhGH) has proven to be safe and efficacious in the setting of CKD-related growth hormone resistance, with the best results experienced by those receiving pre-end-stage renal disease (ESRD) therapy, in contrast to the dialysis and transplant populations. Despite the efficacy of rhGH, its underutilization is prevalent and obstacles to its use must be overcome if the growth of the CKD population is to be optimized.

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Author information

Authors and Affiliations

  1. Division of Pediatric Kidney Services and Hypertension, Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA

    Amira Al-Uzri

  2. Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA

    Annabelle N. Chua

  3. University of Missouri—Kansas City School of Medicine, Kansas City, MO, USA

    Bradley A. Warady

  4. Division of Pediatric Nephrology, Department of Pediatrics, Children’s Mercy Hospital, Kansas City, MO, USA

    Bradley A. Warady

Authors
  1. Amira Al-Uzri
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  2. Annabelle N. Chua
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  3. Bradley A. Warady
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Corresponding author

Correspondence to Bradley A. Warady .

Editor information

Editors and Affiliations

  1. Division of Nephrology and Hypertension, Departments of Medicine and Public Health, University of California Irvine, School of Medicine, Orange, CA, USA

    Connie M. Rhee

  2. Division of Nephrology and Hypertension, Departments of Medicine, Pediatrics, Public Health, and Nursing Sciences, University of California Irvine, School of Medicine, Orange, CA, USA

    Kamyar Kalantar-Zadeh

  3. Division of Endocrinology, Diabetes, and Hypertension, Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Gregory A. Brent

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Al-Uzri, A., Chua, A.N., Warady, B.A. (2019). Growth Hormone Disorders and Abnormal Stature in Kidney Disease. In: Rhee, C., Kalantar-Zadeh, K., Brent, G. (eds) Endocrine Disorders in Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-97765-2_21

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  • DOI: https://doi.org/10.1007/978-3-319-97765-2_21

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-97765-2

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