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

Pediatr Nephrol. 2014 Mar;29(3):439-44. doi: 10.1007/s00467-013-2676-4. Epub 2013 Nov 20.


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.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Body Height*
  • Case-Control Studies
  • Child
  • Child Development*
  • Child, Preschool
  • Energy Intake
  • Female
  • Growth Disorders / etiology
  • Growth Disorders / physiopathology
  • Humans
  • Infant
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Nutritional Status
  • Prospective Studies
  • Renal Dialysis / adverse effects
  • Renal Dialysis / methods*
  • Risk Factors
  • Time Factors
  • Treatment Outcome