NDT Advance Access originally published online on June 7, 2007
Nephrology Dialysis Transplantation 2007 22(10):2879-2885; doi:10.1093/ndt/gfm307
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Incomplete distal renal tubular acidosis affects growth in children
1Department of Paediatrics, Division of Nephrology, 2Department of Paediatrics, Division of Critical Care Medicine, University of Western Ontario, London, Canada, 3Department of Nephrology and 4Department of Urology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India
Correspondence and offprint requests to: Dr Ajay Sharma, E6-123, WT, 800, Commissioner's Road E, London Health Sciences Centre, London, ON, Canada N6A5W9. Email: ajay.sharma{at}lhsc.on.ca
 |
Abstract |
|---|
Background. Incomplete distal renal tubular acidosis (idRTA) is recognized as an underlying aetiology in recurrent nephrolithiasis. Until the recently reported high prevalence of idRTA in adults with osteoporosis, the effect of idRTA on skeletal parameters was not known. We hypothesize that idRTA has a potential to affect height in the paediatric population.
Methods. In a cross-sectional study, the children with posterior urethral valves (PUV), with normal estimated glomerular filtration rates, were evaluated for idRTA and complete dRTA. The idRTA evaluation was done by short ammonium chloride acidification test. The height standard deviation scores (SDS) in the idRTA group were compared with PUV children without dRTA, with complete dRTA, and to age and gender matched controls with no renal issue (n = 50).
Results. The idRTA group (n = 17) manifested a significantly lower mean height SDS (–1.94 ± 0.41 vs –0.46 ± 0.28; P < 0.001) and a higher short stature prevalence (height SDS below 2) (18% vs 0; P = 0.06) as compared with those without dRTA (n = 23). The matched controls showed a significantly higher height SDS as compared with the idRTA group (–0.39 ± 0.25 vs –1.94 ± 0.41; P < 0.001). As compared with the complete dRTA group (n = 9), the children with idRTA did have significantly higher height SDS (–1.94 ± 0.41 vs –5.31 ± 1.95; P = 0.002), and a lower short stature prevalence (18% vs 78%; P = 0.001). On multivariate analysis, dRTA was significantly associated with the height SDS (= –0.88; P < 0.001).
Conclusions. Incomplete dRTA affects height in children. This observation needs validation in longitudinal studies.
Keywords: children; clinical manifestations; distal renal tubular acidosis; height scores; posterior urethral valves
Received for publication: 22. 1.07
Accepted in revised form: 24. 4.07