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Growth and maturation improvement in children on renal replacement therapy over the past 20 years

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Abstract

Background

The attainment of normal growth and maturation remains a major challenge in the management of children and adolescents requiring renal replacement therapy (RRT).

Methods

We compared growth and maturation in 384 German children with RRT who were followed between 1998 and 2009 with 732 children who were enrolled in the European Dialysis and Transplant Association (EDTA) Registry from 1985 to 1988; of these children, 78 and 88 %, respectively, were transplanted.

Results

The data on the German patients included in the EDTA registry did not differ significantly from those of the patients from other European countries. Overall, the mean height standard deviation score (SDS) has improved over the past 20 years from −3.03 to −1.80 (p < 0.001). Until the age of 6 years, the difference in height SDS was not significant, whereas it improved significantly in adolescence (−3.40 vs. −1.52; p < 0.001). Significant improvements in the delay of the pubertal growth spurt, age at menarche, bone maturation and body mass index (BMI) were noted in the recent German group compared to the EDTA group (each p < 0.001).

Conclusions

Our findings demonstrate a marked improvement of growth and maturation in paediatric patients on RRT during the past 20 years.

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Abbreviations

BMI:

Body mass index

CKD:

Chronic kidney disease

EDTA:

European Dialysis and Transplant Association

GH:

Growth hormone

RRT:

Renal replacement therapy

SDS:

Standard deviation score

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Conflict of interest statement

None.

Funding

This project was supported by a grant from the German Federal Ministry of Education and Research (BMBF), reference number 01EO0802. The content of this article is the sole responsibility of the authors.

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Authors and Affiliations

  1. Department of Paediatric Kidney, Liver and Metabolic Diseases, Children’s Hospital, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Doris Franke, Stella Winkel, Lars Pape, Jochen H. H. Ehrich, Dieter Haffner & Miroslav Živičnjak

  2. Department of Paediatric Nephrology, Charité University Hospital, Augustenburger Platz 1, 13353, Berlin, Germany

    Jutta Gellermann & Uwe Querfeld

  3. Faculty of Kinesiology, University of Zagreb, Horvacanski zavoj 15, 10000, Zagreb, Croatia

    Leo Pavičić

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  1. Doris Franke
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  2. Stella Winkel
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  4. Uwe Querfeld
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  5. Lars Pape
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  6. Jochen H. H. Ehrich
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  9. Miroslav Živičnjak
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Correspondence to Miroslav Živičnjak.

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Franke, D., Winkel, S., Gellermann, J. et al. Growth and maturation improvement in children on renal replacement therapy over the past 20 years. Pediatr Nephrol 28, 2043–2051 (2013). https://doi.org/10.1007/s00467-013-2502-z

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  • DOI: https://doi.org/10.1007/s00467-013-2502-z

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