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Growth of children with end-stage renal disease undergoing daily hemodialysis

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Abstract

Background

The aim of this report is to describe the effect of daily hemodialysis on the growth of children with end-stage renal disease (ESRD).

Methods

We performed a prospective, observational study on 24 children with ESRD undergoing daily hemodialysis (DHD). The control group comprised 26 children on concurrent conventional hemodialysis (CHD), and the follow-up for both groups was 9.3 ± 3.0 months. No patient received growth hormone (GH) therapy.

Results

At the onset of the study, the height-for-age Z-score was −2.12 ± 1.54 in the CHD group and −2.84 ± 2.27 in the DHD group (p = 0.313). Assuming an increase of 0.5 standard deviation scores (SDS) of the height-for-age parameter as an improvement of growth, there were 33 % of patients in the DHD group and 8 % in the CHD group (p = 0.035). The cumulative probability of gain in height for age at 12 months was 40 % in the DHD group versus 15 % in the CHD group (p = 0.047). Also, 98 % of patients in the DHD group had an adequate total caloric intake, whereas 38 % in the CHD group reached this goal (p < 0.001). No patient left the study due to intensification of the dialysis modality.

Conclusions

Our data show that the DHD favored a 0.5 SDS height gain in a third of patients without GH treatment. Dialysis intensification was not a cause for treatment dropouts, and DHD should be considered as a treatment for selected cases, especially small children.

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Acknowledgments

This study was conducted at the Hospital Samaritano de Sao Paulo with the support of the Ministry of Health through the Program of support for the institutional development of the National Health System (Programa de apoio ao desenvolvimento Institucional do Sistema Único de Saúde - Proadi/SUS) from March 2008 to March 2010 (Number 25000160163/2008-37).

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Correspondence to Paulo Cesar Koch Nogueira.

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de Camargo, M.F.C., Henriques, C.L., Vieira, S. et al. Growth of children with end-stage renal disease undergoing daily hemodialysis. Pediatr Nephrol 29, 439–444 (2014). https://doi.org/10.1007/s00467-013-2676-4

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  • DOI: https://doi.org/10.1007/s00467-013-2676-4

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