Anthropometric measures and risk of death in children with end-stage renaldisease

We evaluated the association between anthropometric measurements and death among pediatric patients with end-stage renal disease (ESRD) using data fro m the Pediatric Growth and Development Special Study (PGDSS) from the US Re nal Data System. Height, growth velocity, and body mass index (BMI) were us ed for the analysis of 1,949 patients in the PGDSS. To standardize these me asurements, SD scores (SDSs) were calculated using population data from the Third National Health and Nutrition Examination Survey. Using Cox proporti onal hazards models, we assessed the association between anthropometric mea sures and death, controlling for demographic factors and stratifying by age . Multivariate analysis showed that each decrease by 1 SDS in height was as sociated with a 14% increase in risk for death (adjusted relative risk [aRR ], 1.14; 95% confidence interval [CI], 1.02 to 1.27; P = 0.017). For each 1 SDS decrease in growth velocity among patients in our sample, the risk for death increased by 12% (aRR, 1.12; 95% CI, 1.00 to 1.25; P = 0.043). There was a statistically significant ill-shaped association between BMI and dea th (P = 0.001), with relatively low and high BMIs associated with an increa sed risk for death. In children with ESRD, growth delay and extremes in BMI are associated with an increased risk for mortality. (C) 2000 by the Natio nal Kidney Foundation, Inc.