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Growth impairment in children with pre-dialysis chronic kidney disease in Japan

Clinical and Experimental Nephrology volume 19, pages 1142–1148 (2015)Cite this article

Abstract

Background

Growth impairment is a major complication of chronic kidney disease (CKD) in children. However, no cohort studies have examined the growth of Asian children with pre-dialysis CKD.

Methods

We sent cross-sectional surveys to 113 Japanese medical institutions that were treating 447 children with CKD stages 3–5 in 2010 and 2011. Of 447 children included in our survey conducted in 2010, height and CKD stage were evaluable for 297 children in 2011, and height standard deviation score (height SDS) was calculated in these children.

Results

Height SDS decreased with increasing CKD stage (P < 0.001) in boys and girls. Height SDS also decreased significantly with increasing CKD stage among patients with congenital anomalies of the kidney and urinary tract (P < 0.001). Risk factors for growth impairment included CKD stages 4 and 5 (relative to stage 3), being small-for-date, and asphyxia at birth. Among children with a height SDS ≤−2.0, growth hormone was used in 19.5, 31.0, and 25.0 % of children with CKD stages 3, 4, and 5, respectively.

Conclusions

This prospective cohort study revealed marked growth impairment in Japanese children with CKD stages 3–5 relative to healthy children. CKD-related risk factors for growth impairment included advanced CKD (stages 4 and 5), being small-for-date, and asphyxia at birth. Growth hormone was infrequently used in this cohort of children with pre-dialysis CKD.

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Acknowledgments

This work was supported by ‘Research on Rare and Intractable Diseases, Health and Labour Sciences Research Grants’ from the Ministry of Health, Labour and Welfare, Japan. The results presented in this paper have not been published previously in whole or part, except in abstract format. The authors would like to thank Drs. Takuhito Nagai (Aichi), Kenichi Satomura (Osaka), Midori Awazu (Tokyo), Toshiyuki Ohta (Hiroshima), Kazumoto Iijima (Hyogo), Takeshi Matsuyama (Tokyo), Mayumi Sako (Tokyo), Hidefumi Nakamura (Tokyo), Shuichiro Fujinaga (Saitama), Hiroshi Kitayama (Shizuoka), Naoya Fujita (Shizuoka), Masataka Hisano (Chiba), Yuko Akioka (Tokyo), Daishi Hirano (Tokyo), Hiroshi Hataya (Tokyo), Shunsuke Shinozuka (Tokyo), Ryoko Harada (Tokyo), Yoshinobu Nagaoka (Hokkaido), Takashi Sekine (Tokyo), Yoshimitsu Goto (Aichi), Takuji Yamada (Aichi), Yohei Ikezumi (Niigata), Takeshi Yamada (Niigata), and Akira Matsunaga (Yamagata) of The Pediatric CKD Study Group in Japan for their contributions to the study. The authors also thank the institutions listed in the Supplementary Table for participating in the surveys, and Mr. Masaaki Kurihara, Ms. Chie Matsuda and Ms. Naomi Miyamoto of the Japan Clinical Research Support Unit (Tokyo) for their help with data management.

Conflict of interest

Kenji Ishikura has received lecture fees and travel expenses from Novartis Pharma and Asahi Kasei Pharma. Osamu Uemura has received lecture fees and travel expenses from Asahi Kasei Pharma and Siemens Group in Japan. Yuko Hamasaki has received research grants from Novartis Pharma, and lecture fees from Novartis Pharma, Astellas Pharma, and Pfizer Japan. Ryojiro Tanaka has received lecture fees from Pfizer Japan. Koichi Nakanishi has received lecture fees from Novartis Pharma, Asahi Kasei Pharma, and Astellas Pharma. Masataka Honda has received lecture fees from Novartis Pharma and Asahi Kasei Pharma.

Author information

Affiliations

  1. Department of Pediatric Nephrology, Toho University Faculty of Medicine, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan

    Yuko Hamasaki

  2. Department of Nephrology, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan

    Kenji Ishikura & Masataka Honda

  3. Division of Clinical Research Support Center, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan

    Kenji Ishikura & Tetsuji Kaneko

  4. Department of Pediatric Nephrology, Aichi Children’s Health and Medical Center, Aichi, Japan

    Osamu Uemura

  5. Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Shuichi Ito

  6. Department of Pediatric Nephrology, Shizuoka Children’s Hospital, Shizuoka, Japan

    Naohiro Wada

  7. Department of Pediatric Nephrology, Tokyo Women’s Medical University, Tokyo, Japan

    Motoshi Hattori

  8. Department of Integrated Science and Technology for Sustainable Society, Chuo University, Tokyo, Japan

    Yasuo Ohashi

  9. Department of Nephrology, Hyogo Prefectural Children’s Hospital, Hyogo, Japan

    Ryojiro Tanaka

  10. Department of Pediatrics, Wakayama Medical University, Wakayama, Japan

    Koichi Nakanishi

Authors
  1. Yuko Hamasaki
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  2. Kenji Ishikura
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  3. Osamu Uemura
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  4. Shuichi Ito
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  5. Naohiro Wada
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  6. Motoshi Hattori
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  7. Yasuo Ohashi
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  8. Ryojiro Tanaka
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  9. Koichi Nakanishi
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  10. Tetsuji Kaneko
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  11. Masataka Honda
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Corresponding author

Correspondence to Yuko Hamasaki.

Additional information

On behalf of The Pediatric CKD Study Group in Japan in conjunction with the Committee of Measures for Pediatric CKD of the Japanese Society of Pediatric Nephrology.

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Cite this article

Hamasaki, Y., Ishikura, K., Uemura, O. et al. Growth impairment in children with pre-dialysis chronic kidney disease in Japan. Clin Exp Nephrol 19, 1142–1148 (2015). https://doi.org/10.1007/s10157-015-1098-y

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  • DOI: https://doi.org/10.1007/s10157-015-1098-y

Keywords

  • Child
  • Chronic kidney disease
  • Growth
  • Growth hormone
  • Japan