GROWTH-RATES IN PEDIATRIC DIALYSIS PATIENTS AND RENAL-TRANSPLANT RECIPIENTS

We compared growth rates by modality over a 6- to 14-month period in 1 ,302 US pediatric end-stage renal disease (ESRD) patients treated duri ng 1990. Modality comparisons were adjusted for age, sex, race, ethnic ity, and ESRD duration using linear regression models by age group (0. 5 to 4 years, 5 to 9 years, 10 to 14 years, and 15 to 18 years). Growt h rates were higher in young children receiving a transplant compared with those receiving dialysis (ages 0.5 to 4 years, Delta = 3.1 cm/yr v continuous cycling peritoneal dialysis [CCPD], P < 0.01; ages 5 to 9 years, Delta = 2.0 to 2.6 cm/yr v CCPD, chronic ambulatory peritoneal dialysis (CAPD), and hemodialysis, P < 0.01). In contrast, growth rat es in older children were not statistically different when comparing t ransplantation with each dialysis modality, For most age groups of tra nsplant recipients, we observed faster growth with alternate-day versu s daily steroids that was not fully explained by differences in allogr aft function, Younger patients ((15 years) grew at comparable rates wi th each dialysis modality, while older CAPD patients grew faster compa red with hemodialysis or CCPD patients (P < 0.02), There was no substa ntial pubertal growth spurt in transplant or dialysis patients, This n ational US study of pediatric growth rates with dialysis and transplan tation shows differences in growth by modality that vary by age group. (C) 1997 by the National Kidney Foundation, Inc.