Growth Failure In Children With Chronic Kidney Disease
Growth failure is a complication of chronic kidney disease in which the children do not grow as expected. It has been known that about one-third of children diagnosed with chronic kidney disease(CKD) have growth failure. Studies have found that many factors cause growth failure in children with CKD. Apart from removing waste and excess fluid from the body, the kidneys also play important role in the growth of a child.
How does damaged kidneys affect growth in children
Damaged kidneys can slow down growth in a child by
- Preventing the body from making correct use of the growth hormones.
- Producing abnormally large amount of urine by which the affected child not only lose fluid, but minerals as well.
- Creating an imbalance in the blood (acidosis). When this happens,the body slows growth to focus energy on reinstating the balance.
- Acute decrease the production of erythropoietin .When these levels are low, a child may develop Anemia, which can cause growth to slow down or stop.
- Malnutrition. A child with CKD may not have the energy or appetite to eat, thereby leading to poor nutrition and slower growth.
- Causing mineral and bone disorder which may occur when the bones are starved of calcium, or when the phosphorus level increases in the blood, therefore weakening the bones.
Treatment of growth failure in children with CKD.
It is very important to start the treatment of growth failure in children very early because most children with growth failure grow to about one-third of their adult height within the first two years of life. Doctors may recommend some of the following treatments:
- Growth hormone therapy
- Changes in eating, diet and nutrition.
- Synthetic erythropoietin, may be injected to treat Anemia
- When phosphorus levels rise or increases, a phosphate binder may be prescribed
- Alkaline agent such as sodium bicarbonate may also be prescribed to restore balance in a child with acidosis
Growth hormone therapy
Growth hormone is used to replace the body’s lack of growth hormone. It is an artificial hormone injected daily into the body to enhance growth. Nutritional deficiency or metabolic disorder should be reformed preceding the growth hormone therapy.
Changes in eating, diet and nutrition
Some of the following may be recommend
- It is necessary to monitor the intake of sodium. Adding or reducing salt to the child’s diet, depending on the stage of the CKD
- In a situation whereby the child is not getting vitamin D through diet, the supplement would be recommended.
- Limiting phosphorus intake if the child is having mineral and bone disorder
- Calcium intake from diet or in form of supplement is recommended
- High protein should be avoided because it can be excess burden on the kidneys
- Liquid intake should be monitored. Some children might need to increase liquid intake while others might be restricted.