Treatment of Renal Osteodystrophy in Children and Adolescents with Chronic Kidney Disease and Height Deficits
Renal osteodystrophy in the pediatric population presents distinct challenges when chronic kidney disease (CKD) disrupts normal skeletal growth. In children and adolescents with CKD stages G2 through G5D, height deficits are a recognised consequence that requires a targeted clinical approach.
Clinical Scenario
Children and adolescents with CKD G2–G5D — including those on dialysis — who have developed related height deficits. The presence of chronic kidney disease shapes both the metabolic environment and the therapeutic priorities for this population.
Treatment Approach
Management involves a growth-promoting hormone therapy, but initiation requires specific prerequisite steps addressing underlying nutritional and metabolic abnormalities of CKD-related mineral and bone disorder first. The complete sequencing, criteria, and clinical details are available in the full protocol.
Treatment Goal
Additional linear growth — an increase in height toward age-appropriate norms.
References
DOI: 10.1038/ki.2009.191
In children and adolescents with CKD G2–G5D and related height deficits, we recommend treatment with recombinant human growth hormone when additional growth is desired, after first addressing malnutrition and biochemical abnormalities of CKD-MBD (1A).
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