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Pathogenesis, evaluation and diagnosis of growth impairment in children with chronic kidney disease

Author
Burkhard Tönshoff, MD, PhD
Section Editor
Patrick Niaudet, MD
Deputy Editor
Melanie S Kim, MD

INTRODUCTION

Growth impairment is a major complication of children with chronic kidney disease (CKD). Poor growth is a marker of disease severity and is associated with significant morbidity and mortality [1,2].

The impact, pathogenesis, evaluation, and diagnosis of growth impairment in children with CKD will be reviewed here. The management of growth impairment is discussed separately. (See "Prevention and management of growth failure in children with chronic kidney disease" and "Growth hormone treatment in children with chronic kidney disease and postrenal transplantation".)

DEFINITIONS

Chronic kidney disease — The Kidney Disease: Improving Global Outcomes (KDIGO) 2012 Clinical Practice Guideline for Evaluation and Management of Chronic Kidney Disease revised the 2002 classification of pediatric CKD by the Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guideline for Chronic Kidney Disease [3,4]. (See "Epidemiology, etiology, and course of chronic kidney disease in children", section on 'Definitions and classifications'.)

The KDIGO guideline also includes CKD staging for children older than two years of age, and stratifies the risk for progression of CKD and its complications based on glomerular filtration rate (GFR). This classification is used to guide management, including what therapeutic interventions should be initiated and when (table 1):

G1 – Normal GFR (≥90 mL/min per 1.73 m2)

                          

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Literature review current through: Nov 2016. | This topic last updated: Mon Feb 22 00:00:00 GMT+00:00 2016.
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