Abstract
The Centers for Medicare & Medicaid Services’ (CMS) end-stage renal disease (ESRD) Clinical Performance Measures (CPM) Project has collected data on all adolescent hemodialysis patients since 2000. Thus, by 2002 data were available on all adolescents on hemodialysis in the USA for 3 consecutive years. Possible associations between clinical parameters and linear growth in this cohort were evaluated. Ninety-four adolescents were on hemodialysis for the 3 study years. The mean height standard deviation score (ht SDS) fell from −1.97 to −2.36 over the 3 study years. Compared with patients with ht SDS ≥−1.88, patients with ht SDS <−1.88 in the 2002 study year (n =53) were more likely to be male (66% vs 44%, p <0.05), on dialysis longer (6.9±4.5 years vs 4.1±2.3 years, p <0.001), and had lower height SDS in the 2000 study year (−2.90±1.31 vs −0.772±1.10, p <0.001). Patients with a ht SDS <−1.88 had a lower mean hemoglobin (11.4±1.6 g/dl vs 12.0±1.1 g/dl, p <0.05), but there were no differences in other clinical parameters. Among patients with ht SDS <−1.88, 38.8% (n =20) were prescribed recombinant human growth hormone (rhGH) in the 2002 study year. There were no differences in demographic or clinical parameters between rhGH treated and untreated patients. Many adolescents who remain on hemodialysis have poor linear growth. Further evaluation is needed to delineate contributory factors and the possible underutilization of rhGH.
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References
Daugirdas JT (2003) Second generation logarithmic estimates of single-pool variable volume Kt/V: an analysis of error. J Am Soc Nephrol 4:1205–1213
Goldstein SL (2001) Hemodialysis in the pediatric patient: state of the art. Adv Ren Replac Ther 8:173–179
Fine RN, Sullivan EK, Tejani A (2000) The impact of recombinant human growth hormone treatment on final adult height. Pediatr Nephrol 14:679–681
Haffner D, Schaefer F, Nissel R, Wuhl E, Tonshoff B, Mehls O (2000) Effect of growth hormone treatment on the adult height of children with chronic renal failure. German Study Group for Growth Hormone Treatment in Chronic Renal Failure. N Engl J Med 28:923–930
Breard E, Crosnier H, Sex-Beneton A, Chevallier T, Cochat P, Broyer (1998) Recombinant human growth hormone treatment of children on hemodialysis. Pediatr Nephrol 12:304–310
Neu AM, Ho PL, McDonald RA, Warady BA (2002) Chronic dialysis in children and adolescents. The 2001 NAPTRCS Annual Report. Pediatr Nephrol 17:656–663
Wong CS, Gipson DS, Gillen DL, Emerson S, Koepsell T, Sherrard DJ, Watkins SL, Stehman-Breen C (2000) Anthropmetric measures and risk of death in children with end-stage renal disease. Am J Kidney Dis 36:811–819
Furth SL, Hwang W, Yang C, Neu AM, Fivush BA, Powe NR (2002) Growth failure, risk of hospitalization and death for children with end-stage renal disease. Pediatr Nephrol 17:450–455
Furth SL, Stablein D, Fine RN, Powe NR, Fivush BA (2002) Adverse clinical outcomes associated with short stature at dialysis initiation: A report of the North American Pediatric Renal Transplant Cooperative Study. Pediatrics 5:909–913
Qureshi AR, Alvestrand A, Divino-Filho JC, Gutierrez A, Heimbürger O, Lindholm B, Bergström J (2002) Inflammation, malnutrition, and cardiac disease as predictors of mortality in hemodialysis patients. J Am Soc Nephrol 13:S28–36
Menon V, Wang X, Greene T, Beck GJ, Kusek JW, Marcovina SM, Levey AS, Sarnak MJ (2003) Relationship between C-reactive protein, albumin, and cardiovascular disease in patients with chronic kidney disease. Am J Kidney Dis 42:44–52
Goldstein SL, Currier H, Watters L, Hempe JM, Sheth RD, Silverstein D (2003) Acute and chronic inflammation in pediatric patients receiving hemodialysis. J Pediatr 143:653–657
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These data were presented in part at the 2003 Pediatric Academic Societies’ Meeting, Seattle, Washington, May 2003, and the American Society of Nephrology 36th Annual Meeting and Scientific Exposition, San Diego, CA, November 2003.
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The views expressed in this manuscript are those of the authors and do not necessarily reflect official policy of the Centers for Medicare & Medicaid Services
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Neu, A.M., Bedinger, M., Fivush, B.A. et al. Growth in adolescent hemodialysis patients: Data from the Centers for Medicare & Medicaid Services ESRD Clinical Performance Measures Project. Pediatr Nephrol 20, 1156–1160 (2005). https://doi.org/10.1007/s00467-005-1889-6
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DOI: https://doi.org/10.1007/s00467-005-1889-6