| [ Summary ] |
Growth impairment in children with CKD is caused by multiple factors, including a glomerular filtration rate below 60 mL/min/1.73 m2, which also indicates chronic kidney disease. During CKD stages 3-5, treatment with recombinant human growth hormone is recommended, as well as avoidance of malnutrition and CKD bone mineral disorders. Renal transplantation preemptively or following short term dialysis should be performed. After transplantation, corticosteroids should be reduced or withdrawn. If graft function remains ideal, catch-up growth is observed in most patients. According to a multicenter study in Japan, mean final height in pediatric transplant recipients treated with calcineurin inhibitor after transplantation was 158 cm in men and 148 cm in women. Their mean final height did not reach average Japanese adult height or target height calculated from parental heights. Aggressive management of growth retardation before transplantation may improve height during adulthood of children with CKD. |