Indicator Details — Children and Adolescents: CKD Associated with Short Stature in the Pediatric Populationa
Data Sources
 
Stratification and Year Choices:

  Source
  • CKiD

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Published literature or one-time analysis, ongoing surveillance not available Published literature or one-time analysis, ongoing surveillance not available

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Footnotes:
a The difference in the median age-sex-specific height standard deviation scores (SDS) of children with nonglomerular CKD compared with children with glomerular CKD has a p-value of 0.003.




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. 2014;29(10):1987-1995.
http://www.ncbi.nlm.nih.gov/pubmed/24728472
FieldData
Description of MeasureHeight deficits among children with CKD
Data SourceCKiD prospective observational cohort study
Type of Data SourcePrivate
Data SetCKiD summarized data
Health Care System DataNo
Regional or National?National
Demographic Group
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)
NumeratorAge-sex-specific height for study participants 
DenominatorAge-sex-specific height for the general population
Definition of CKDPlasma 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 IndicatorHeight
Primary Indicator Method of MeasurementHeight was determined via a stadiometer
Frequency of Measurement (Primary)Once
Period Currently Available2013
Pending DataNone
U.S. Region Covered by Primary VariableAll
Additional Data Items of InterestAge-sex-specific weight and BMI
Limitations of IndicatorAge-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 IndicatorAs 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.
    http://www.ncbi.nlm.nih.gov/pubmed/24728472
Suggested Citation:
Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System—United States.
website. http://www.cdc.gov/ckd