The relation between vitamin D, calcium, and phosphor in growth retardation of child with chronic kidney disease
Main Article Content
Keywords
Chronic Kidney Disease, Vitamin D, Calcium, Phosphorus, Growth Retardation
Abstract
Background: Growth retardation was a complication in chronic kidney disease (CKD). It is a condition that a child can not achieve linear potential growth. Fifty percent of children with CKD will have a height below the third percentile. The causes of growth disorders in CKD are multifactorial. Electrolyte hemostasis (calcium and phosphorus) and lack of vitamin D play a role in growth in children with CKD. The aim of this study was to determine the relationship between growth problems in children with chronic kidney disease and the correlation with vitamin D, calcium, and phosphorus.
Method: This study was a retrospective observational analytical study design. The research subjects were taken from medical records from Saiful Anwar General Hospital in Malang from January 1st to December 2019. 68 pediatric patients aged 2 – 18 years old were diagnosed with chronic kidney disease, divided into 2 groups (with growth retardation and normal stature). Data were analyzed using SPSS
v.26 for windows.
Results: There was significant correlation between low vitamin D levels and growth retardation (p = 0.005), and significant correlation between calcium levels (p = 0.026) and phosphor levels (p = 0.222) and the incidence of growth retardation. Levels of vitamin D, calcium, and phosphor have a positive correlation with growth retardation 0.427, 0.277, dan 0.300 (p<0.05). Path analysis found a significant direct relationship between vitamin D on growth retardation (β = 0.358, p = 0.002) and had a greater effect when compared to the indirect relationship between vitamin D and growth retardation mediated by calcium and phosphorus.
Conclusion: there is a correlation between vitamin D, calcium, and phosphorus with growth retardation in children with chronic kidney disease.
References
2. Rahmadi FA, Hardaningsih G, Pratiwi R. Prevalensi dan jenis masalah emosional dan perilaku pada anak usia 9-11 tahun dengan perawakan pendek di Kabupaten Brebes. J Gizi Indones (The Indones J Nutr. 2016;3(2):116–9. Available from: http://dx.doi.org/10.14710/jgi.3.2.116-119
3. Salević P, Radović P, Milić N, Bogdanović R, Paripović D, Paripović A, et al. Growth in children with chronic kidney disease: 13 years follow up study. J Nephrol. 2014;27(5):537–44. Available from: http://dx.doi.org/10.1007/s40620-014-0094-8
4. Salas P, Pinto V, Rodriguez J, Zambrano MJ, Mericq V. Growth retardation in children with kidney disease. Int J Endocrinol. 2013/09/25. 2013;2013:970946. Available from: https://pubmed.ncbi.nlm.nih.gov/24187550
5. Silverstein DM. Growth and Nutrition in Pediatric Chronic Kidney Disease. Front Pediatr. 2018;6:205. Available from: https://pubmed.ncbi.nlm.nih.gov/30155452
6. &NA; 3. Essentials of Pathophysiology: Concepts of Altered Health States. AJN, Am J Nurs. 2004;104(1):89. Available from: http://dx.doi.org/10.1097/00000446-200401000-00053
7. Chadha V, Warady BA. Epidemiology of Pediatric Chronic Kidney Disease. Adv Chronic Kidney Dis. 2005;12(4):343–52. Available from: http://dx.doi.org/10.1053/j.ackd.2005.07.013
8. Halle MP, Lapsap CT, Barla E, Fouda H, Djantio H, Moudze BK, et al. Epidemiology and outcomes of children with renal failure in the pediatric ward of a tertiary hospital in Cameroon. BMC Pediatr. 2017;17(1):202. Available from: https://pubmed.ncbi.nlm.nih.gov/29212494
9. Harambat J, van Stralen KJ, Kim JJ, Tizard EJ. Epidemiology of chronic kidney disease in children. Pediatr Nephrol. 2011/06/29. 2012;27(3):363–73. Available from: https://pubmed.ncbi.nlm.nih.gov/21713524
10. Lalayiannis AD, Crabtree NJ, Fewtrell M, Biassoni L, Milford D V, Ferro CJ, et al. Assessing bone mineralisation in children with chronic kidney disease: what clinical and research tools are available? Pediatr Nephrol. 2019/06/25. 2020;35(6):937–57. Available from: https://pubmed.ncbi.nlm.nih.gov/31240395
11. Seikaly MG, Salhab N, Gipson D, Yiu V, Stablein D. Stature in children with chronic kidney disease: analysis of NAPRTCS database. Pediatr Nephrol. 2006;21(6):793–9. Available from: http://dx.doi.org/10.1007/s00467-006-0040-7
12. Park SJ, Shin J Il. Complications of nephrotic syndrome. Korean J Pediatr. 2011/08/31. 2011;54(8):322–8. Available from: https://pubmed.ncbi.nlm.nih.gov/22087198
13. Seeherunvong W, Abitbol CL, Chandar J, Zilleruelo G, Freundlich M. Vitamin D Insufficiency and Deficiency in Children with Early Chronic Kidney Disease. J Pediatr. 2009;154(6):906-911.e1. Available from: http://dx.doi.org/10.1016/j.jpeds.2008.12.006
14. Chau Y-Y, Kumar J. Vitamin D in chronic kidney disease. Indian J Pediatr. 2012/04/29. 2012;79(8):1062–8. Available from: https://pubmed.ncbi.nlm.nih.gov/22544696
15. Hruska KA, Mathew S, Lund R, Qiu P, Pratt R. Hyperphosphatemia of chronic kidney disease. Kidney Int. 2008/04/30. 2008;74(2):148–57. Available from: https://pubmed.ncbi.nlm.nih.gov/18449174