Female children with CKD (median height standard deviation scores (SDS): -0.68, interquartile range (IQR): -1.46 to 0.13) had a greater height deficit than male children with CKD (median: -0.49, IQR: -1.30 to 0.24), though the gender difference was not statistically significant (p=0.065).
Height deficits in the pediatric CKD population differed significantly according to primary CKD diagnosis. The median age-sex-specific height SDS of children with nonglomerular CKD was significantly greater than children with glomerular CKD (-0.62 vs. -0.33; p= 0.003).
Chart Explanation: CKD is strongly associated with growth impairment in the pediatric population. Age-sex-specific height standard deviation scores (SDS) were calculated for the Chronic Kidney Disease in Children (CKiD) cohort using CDC growth charts and United States normative data. SDS scores indicate the number of standard deviations the participant is above or below the expected mean value for their age and sex. A comparison of the normative data to the data from the CKiD cohort indicates that children with CKD are substantially shorter than the average child living in the United States (median age-sex-specific SDS = -0.55; IQR: -1.35, 0.19).
Height deficits in the pediatric CKD population differed significantly according to primary CKD diagnosis. The median age-sex-specific height SDS of children with nonglomerular CKD was significantly more severe than children with glomerular CKD (-0.62 vs. -0.33; p= 0.003). Both female and male children with CKD had height deficits compared to those without CKD; the gender difference was not statistically significant (p= 0.065)
The Chronic Kidney Disease in Children (CKiD) study is a prospective observational study of an estimated 500 children aged 1 to16 years at 48 North American centers with varying degrees of CKD severity, which was designed to measure consequences in pediatric CKD patients. As with all cohort studies, recruitment bias and lack of representativeness may influence estimates.
This indicator is based upon analysis in published literature: Rodig NM, McDermott KC, Schneider MF, et al. Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children Study. Pediatr Nephrol
|Description of Measure||Height deficits among children with CKD|
|Data Source||CKiD prospective observational cohort study|
|Type of Data Source||Private|
|Data Set||CKiD summarized data|
|Health Care System Data||No|
|Regional or National?||National|
Children aged 1 to 16 years with mild to moderate CKD (Schwartz-estimated GFR of 30-90 ml/min/1.73 m²) who are treated throughout 48 pediatric nephrology centers in North America (46 U.S., 2 Canadian centers)
|Numerator||Age-sex-specific height for study participants |
|Denominator||Age-sex-specific height for the general population|
|Definition of CKD||Plasma disappearance of iohexol was used to measure GFR as previously published by Schwartz, et al. (Glomerular filtration rate via plasma iohexol disappearance: pilot study for chronic kidney disease in children. Kidney Int. 2006; 69:2070–2077)|
|Primary Data Source Indicator||Height|
|Primary Indicator Method of Measurement||Height was determined via a stadiometer|
|Frequency of Measurement (Primary)||Once|
|Period Currently Available||2013|
|U.S. Region Covered by Primary Variable||All|
|Additional Data Items of Interest||Age-sex-specific weight and BMI|
|Limitations of Indicator||Age-sex-specific height may not be an accurate way to assess growth in children given the fact that short stature can also be affected by sexual maturation; nutritional intake was not available for this analysis|
|Analytical Considerations of Indicator||As with all cohort studies, selection bias and possible confounding|
References and Sources:
Rodig NM, McDermott KC, Schneider MF, et al. Growth in children with chronic kidney disease: a report from the Chronic Kidney Disease in Children Study. Pediatr Nephrol. 2014;29(10):1987-1995.