TAILIEUCHUNG - Growth Monitoring Guidelines for Children with Chronic Kidney Disease

These cross-country differences may provide information on the effectiveness of national health systems. However, they may also reflect other factors—such as differences in research methods, sample sizes, sample periods and variable definitions. This paper re-examines differences between American and English income gradients in children’s health, paying careful attention to these issues. We find that, when the English sample is expanded by adding three years of data, and is compared to American data from the same time period, the income gradient in children’s health increases with age by the same amount in the two countries. It is still the case. | Growth Monitoring Guidelines for Children with Chronic Kidney Disease Contents Page 1 Scope Background and Rationale for guideline Page 2 Table of Guidelines for Required Growth Monitoring Page 3 Appendix 1 Definition of Stages of Chronic Kidney Disease CKD Page 4-5 Appendix 2 RCPCH UK-WHO Factsheet 6 Page 6 Appendix 3 RCPCH UK-WHO Factsheet 3 Measuring and Plotting Page 7 References The scope of the guideline extends to both specialist renal units and shared care centres including those where children are seen by non-specialist paediatricians. This guideline provides guidance on the monitoring of growth in children with CKD. Where this monitoring indicates concerns regarding growth clinicians should manage and refer cases according to their local or regional clinical referral pathways. Background Growth retardation is well recognised in children with CKD 1 2 9 11J even in children with mild-moderate chronic renal insufficiency2 11. Short stature is associated with increased morbidity and mortality3 4. A combination of regular anthropometric measurements clinical assessment of growth and a nutritional assessment is an essential part of treatment in these children8 15. There is no direct gold standard evidence or specific UK or European consensus guidelines for monitoring the growth of children with moderate to severe renal disease. This document therefore aims to define minimum standards for measuring and monitoring growth in children with CKD based on local expert opinion international committee reports and indirectly supportive peer-reviewed clinical trials and reviews. Multiple measures are necessary15 19 to give a broad and reliable picture of growth and nutrition and the frequency of measurement will depend on the child s age and stage of CKD see appendix 1 . Children displaying growth delay or unstable medical or nutritional status will require more frequent monitoring20 as will those with more complex social or medical problems. The rationale for the .

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