Normal statural growth in 2 infants on chronic peritoneal dialysis: anecdotal or whole management-related.
Clin Nephrol
; 56(6): S17-20, 2001 Dec.
Article
em En
| MEDLINE
| ID: mdl-11770806
ABSTRACT
AIMS:
Growth retardation is usual in children on chronic peritoneal dialysis (CPD). Despite attention to many contributing factors (nutrition, dialysis dose, hemoglobin level, adynamic bone disease, hyperparathyroidism or rickets, growth hormone resistance, etc.), normal growth is rarely obtained in infants on CPD. MATERIALS ANDMETHODS:
We had the chance to observe normal growth over a 1 year period in 2 consecutively treated infants on CPD. Louise (renal hypodysplasia) required CPD at the age of 1 month creatinine 430 micromol/l; oliguric, creatinine clearance lower than 5 ml/min/1.73 m2. Nutrition was achieved orally with human milk during the first 6 months of life. Tidal peritoneal dialysis allowed a high dialysis dose Kt/V urea 3.8/week and Kcreatinine 105 l/week/1.73 m2. Hemoglobin was maintained over 13 g/dl and low levels of vitamin D analogue were prescribed to avoid adynamic bone disease. At the age of 1 year her height was 75 cm. i.e. in the normal range for age. Madeline (renal hypodysplasia) commenced on CPD at the age of 6 weeks and managed similarly. Her height at 1 year of age was 74 cm.RESULTS:
In our 20 years of experience with children on dialysis, these 2 cases of normal statural growth for age at 1 year warrant discussion. As well as nutritional support, the new and recent therapeutic options in our team were firstly, to avoid high doses of activated vitamin D to control PTH, as high doses are able to induce both a risk of adynamic bone disease and a direct bone cartilage toxicity secondly, to maintain normal hemoglobin level; and thirdly, to deliver a high dialysis dose (urea, creatinine clearance) based on an individually adapted prescription.CONCLUSION:
We feel this management approach is necessary to achieve optimal statural growth in children on chronic peritoneal dialysis. But this management concept only based on clinical anecdotal observations needs further evaluation before its use in clinical guidelines.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estatura
/
Peso Corporal
/
Diálise Peritoneal
/
Apoio Nutricional
/
Falência Renal Crônica
Tipo de estudo:
Guideline
/
Qualitative_research
Limite:
Female
/
Humans
/
Infant
Idioma:
En
Revista:
Clin Nephrol
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
França