Outcome and growth of infants with severe chronic renal failure

Background We aimed to assess the outcome and growth of infants with severe chronic renal failure (CRF). One hundred and one children presented betwee n January 1, 1986, and December 12, 1998, with a glomerular filtration rate (GFR) of <20 mL/min/1.73 m(2). The median (range) age at presentation was 0.3 (0 to 1.5) years, and follow-up was 7.6 (1.5 to 13) years. One- and fiv e-year survival rates were 87 and 78%,respectively. The growth of the 81 ch ildren who survived over two years was evaluated. Eighty-one percent were e nterally fed from age 0.7 (0 to 4.5) years for 1.9 (0.1 to 6.8) years. Fort y-six percent had a gastrostomy, and 22% a Nissen fundoplication. Twenty-fi ve were managed conservatively. Twenty were transplanted without dialysis a t age 4 (1.7 to 8.5) years, and 36 were dialyzed at age 1.1 (0 to 9.8) befo re transplantation at age 2.4 (1.3 to 10) years. Results. The mean (SD) height standard deviation score increased from -2.16 (1.34) at 6 months (N = 63) to -1.97 (1.37) at 1 year (N = 75), -1.79 (1.2 9) at 2 years (N = 75), -1.33 (1.29) at 3 years (N = 68, P = 0.0006), -1.27 (1.04) at 5 years (N = 47, P = 0.0001), and -0.85 (0.82) at 10 years (N = 18, P = 0.001). The body mass index was in the normal lange in the majority of patients. Conclusion. Mortality in infants with CRF occurs mainly in the first year o f life. With early enteral feeding, the mean height standard deviation scor e is within the normal range from one year of age.