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Incidence of and risk factors for short stature in children with chronic kidney disease: results from the KNOW-Ped CKD

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Abstract

Background

Preserving optimal growth has long been a significant concern for children with chronic kidney disease (CKD). We aimed to examine the incidence of and risk factors for short stature in Asian pediatric patients with CKD.

Methods

We analyzed growth status by height, weight, and body mass index (BMI) standard deviation scores (SDSs) for 432 participants in the KoreaN cohort study for Outcome in patients With Pediatric Chronic Kidney Disease.

Results

The median height, weight, and BMI SDSs were − 0.94 (interquartile range (IQR) − 1.95 to 0.05), − 0.58 (IQR − 1.46 to 0.48), and − 0.26 (IQR − 1.13 to 0.61), respectively. A high prevalence of short stature (101 of 432 patients, 23.4%) and underweight (61 of 432 patients, 14.1%) was observed. In multivariable logistic regression analysis, CKD stages 4 and 5 (adjusted odds ratio (aOR) 2.700, p = 0.001), onset before age 2 (aOR 2.928, p < 0.0001), underweight (aOR 2.353, p = 0.013), premature birth (aOR 3.484, p < 0.0001), LBW (aOR 3.496, p = 0.001), and low household income (aOR 1.935, p = 0.030) were independent risk factors associated with short stature in children with CKD.

Conclusions

Children with CKD in Korea were shorter and had lower body weight and BMI than the general population. Short stature in children with CKD was most independently associated with low birth weight, followed by premature birth, onset before age 2, CKD stages 4 and 5, underweight, and low household income. Among these, underweight is the only modifiable factor. Therefore, we suggest children with CKD should be carefully monitored for weight, nutritional status, and body composition to achieve optimal growth.

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Availability of data, code, and material

Requests for access to data from the study should be addressed to the corresponding author at kanghg@snu.ac.kr. All proposals requesting data access will need to specify how they plan to use the data, and all proposals will need approval of the trial co-investigator team before data release.

Funding

This study was supported by the Research Program funded by the Korea Centers for Disease Control and Prevention (fund codes 2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, 2016E3300200, 2016E3300201, 2016E3300202, 2019E320100, 2019E320101, and 2019E320102).

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Author notes

  1. Eujin Park and Hye Jin Lee contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea

    Eujin Park & Hye Jin Lee

  2. Department of Pediatrics, Seoul National University Children’s Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea

    Hyun Jin Choi, Yo Han Ahn, Seong Heon Kim, Il-Soo Ha & Hee Gyung Kang

  3. Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea

    Yo Han Ahn, Il-Soo Ha & Hee Gyung Kang

  4. Kidney Research Institute, Seoul National University Medical Research Center, Seoul, South Korea

    Yo Han Ahn, Il-Soo Ha & Hee Gyung Kang

  5. Department of Pediatrics, Jeju National University, College of Medicine and Graduate School of Medicine, Jeju, South Korea

    Kyoung Hee Han

  6. Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, South Korea

    Seong Heon Kim

  7. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Heeyeon Cho

  8. Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea

    Jae Il Shin

  9. Division of Pediatric Nephrology, Severance Children’s Hospital, Seoul, South Korea

    Jae Il Shin

  10. Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Joo Hoon Lee & Young Seo Park

  11. Department of Pediatrics, Kyungpook National University, School of Medicine, 130 Dongdeok-ro,Jung-gu, Daegu, 41944, South Korea

    Min Hyun Cho

  12. Wide River Institute of Immunology, Seoul National University, Hongcheon, South Korea

    Hee Gyung Kang

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  1. Eujin Park
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  10. Young Seo Park
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  11. Il-Soo Ha
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  12. Min Hyun Cho
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Contributions

E.P. contributed to the study conception and drafted the article; H.J.L. contributed to the study design and revised the article; I.H., Y.S.P., J.H.L., J.I.S., H.C., K.H.H., S.H.K., and M.H.C. contributed to data acquisition; H.J.C. and Y.H.A. contributed to the analysis and interpretation of data; H.G.K. provided intellectual content of critical importance to the work described and approved the final version of the article to be published. All authors provided review and final approval of the manuscript to be published.

Corresponding authors

Correspondence to Min Hyun Cho or Hee Gyung Kang.

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Ethics approval

This study was approved by the institutional review boards of the participating centers, namely Jeju National University Hospital (Jeju, South Korea), Pusan National University Children’s Hospital (Yangsan, South Korea), Severance Children’s Hospital (Seoul, South Korea), Kyungpook National University Children’s Hospital (Daegu, South Korea), Seoul National University Children’s Hospital (Seoul, South Korea), Samsung Medical Center (Seoul, South Korea), Asan Medical Center (Seoul, South Korea), and Hallym University Kangnam Sacred Heart Hospital (Seoul, South Korea).

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Informed consent was obtained from the parents of all individual participants according to local requirements.

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The authors declare no competing interests.

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Park, E., Lee, H.J., Choi, H.J. et al. Incidence of and risk factors for short stature in children with chronic kidney disease: results from the KNOW-Ped CKD. Pediatr Nephrol 36, 2857–2864 (2021). https://doi.org/10.1007/s00467-021-05054-3

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