Asia Pacific Journal of Pediatric and Child Health

Abstract Ref Number = APCP1097

Poster Presentation

PREDICTING LINEAR GROWTH IN CHILDREN WITH END STAGE RENAL DISEASE TRADITIONAL PARAMETERS MAY NO LONGER RELEVANT

Tiara Nurlitasari,Suryono Yudha Patria,Retno PalupiBaroto,Kristia Hermawan Faculty of Medicine Public Health and Nursing Universitas Gadjah Mada

Background : Achieving normal linear growth is one of pediatric chronic kidney disease (CKD) patient's treatment goal. Linear growth impairment is considered as manifestation of chronic kidney disease mineral bone disorder (CKD-MBD) that associates with higher mortality risk. Several parameters, such as persistent proteinuria, calcium, phosphorus levels have been traditionally known to correlate with bone CKD-MBD. We investigated correlation between this traditional parameters with linear growth impairment in children with end stage renal disease (ESRD) under renal replacement therapy (RRT) Material : We conducted a retrospective cohort study on patients treated at pediatric nephrology Dr. Sardjito hospital from January 2016 to April 2018. Subject were ESRD patients who underwent RRT. We defined linear growth impairment based on the height for age (H//A) Z-score differences on their onset of diagnosis and at least after 3 months under RRT. We analyzed the association between linear growth impairment and sex, type of RRT, stunting at diagnosis, persistence of proteinuria, suboptimal calcium levels and parathyroid hormone (PTH) level Results : We identified 23 children with ESRD. Of those, 12 (56.5%) children were male, mean age of onset was 12.3 ± 3.45 years.The prevalence of linear growth impairment was 60.9%. Chi square test showed that sex, type of RRT, persistent of proteinuria, suboptimal calcium levels and stunted on diagnosis were not statistically significant as predicting factors for linear growth impairment (OR 4.6, 95%CI 0.702-31.03); (OR 2.6, 95%CI 0.39-17.45); (OR 0.44, 95%CI 0.08-2.45); (OR 0.12, 95%CI 0.012-1.28); (OR 0.38, 95%CI 0.057-2.53). In addition, of 15 children who were examined PTH levels, there was higher mean of PTH level in children with linear growth impairment compared without impairment (562±626.3 vs 293.7±213.5pg/ml; p-value 0.33) Conclusions : Traditional parameters including sex, type of RRT, persistent of proteinuria, suboptimal calcium levels and stunted at onset could not reliably be used to predict linear growth impairment in children with ESRD underwent RRT

Keywords: linear growth impairment end stage renal disease height for age