TULBURĂRILE DE CREŞTERE LA COPII CU BOALĂ CRONICĂ DE RINICHI

Abstract

Introducere. Boala cronică de rinichi (BCR) la copii afectează profund creşterea staturală, prin perturbări ale proceselor de modelare, remodelare şi dezvoltare osoasă. Aceste tulburări se manifestă adesea încă din stadiile incipiente ale bolii, necesitând o intervenţie precoce pentru a preveni întârzierile de creştere. Scop. Scopul lucrării este analiza a principalilor factori care influenţează creşterea staturală la copiii cu boală cronică de rinichi şi a intervenţiilor terapeutice eficiente. Material şi metode. Cercetarea se bazează pe analiza surselor bibliografice care abordează tulburările de creştere la copiii cu BCR, publicate în bazele de date Pub-Med, Google Scholar, Kidney International şi ghidul KDIGO 2024, în perioada 2020-2025, utilizând următoarele

Introduction. In children, chronic kidney disease (CKD) severely affects growth by altering bone development, bone formation, and bone remodeling. These disturbances often begin early in the disease course, emphasizing the importance of early detection and early targeted interventions for preventing growth disorders. Objective. The purpose of the paper is to analyze the main factors that influence height growth in children with chronic kidney disease and to highlight effective therapeutic interventions. Material and methods. The research is based on the analysis of bibliographic sources addressing growth disorders in children with CKD, published in the PubMed, Google Scholar, Kidney International and KDIGO 2024 databases, during the period of 2020-2025, using the following keywords: “chronic kidney disease”, “growth disorders”, “children”. Results. Recent studies report that the prevalence of short stature in children with CKD varies from 30 to 50%. According to North American Pediatric Renal Trials and Collaborative Studies data, 1/3 of children had a height below -1.88 SDS and only 17% of children with CKD had a height SDS > 0. Factors involved in height growth: poor nutritional status, metabolic acidosis, bone mineral disorders, GH-IGF-1 axis imbalance, early age of onset, disease duration and type of treatment. KDIGO recommends monitoring and initiating treatment with recombinant human growth hormone in patients with SDS <-2 or growth velocity below the 3rd percentile. Conclusion. Growth disorders in children with CKD are common and multifactorial. Early intervention and correction of metabolic imbalances supported by nutritional therapy, as well as different dialysis modalities, contribute to a significant improvement in growth in children with CKD.