Chronic renal disease

The kidneys play a vital role in ensuring that urine is excreted at the right concentration. This means that a well functioning kidney will excrete excessive water and waste products while retaining salts and other compounds that the body needs.

Three groups
Children with chronic kidney (renal) disease can be divided into three groups, depending on their level of renal function:

• Chronic renal insufficiency - renal function less than 50%
• Chronic renal failure - renal function less than 25%
• End-stage renal disease - renal function less than 5% (patients in dialysis)

Abnormal growth
Roughly 6 children out of a million of the total population suffer from chronic renal disease. Approximately a third of children with chronic renal disease have abnormal growth, partly because renal diseases disturb the metabolism of growth hormone. The corticosteroid hormones which are often used to treat the kidney disease may also slow growth.

Age
The age that the renal disease starts has more impact on growth retardation than the reduction in renal function (i.e. the younger the child when the disease starts, the more retarded is his or her growth). Treatment with human growth hormone can minimise their growth retardation. Today treatment is usually stopped if a child has a kidney transplant.

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