Question

Jason is a nine-year-old child who developed chronic renal failure after suffering from a streptococcal infection (strep throat). Jason's renal function has declined steadily over the last three years, and he is currently receiving hemodialysis three times a week. A search is on for a suitable kidney donor. Jason is 4 feet 3 inches tall and weighs 55 pounds. He fol- lows a fluid-, sodium-, potassium-, and phosphorus-restricted diet, His typical energy intake is about 1000 kcalories per day.

My question is:
Look at Jason's height and weight. Use a growth chart to determine how Jason's height and weight compare to those of other children of the same age and discuss reasons why growth may be compromised in a child with renal failure.

Answer 1

Jason is 4 feet 3 inches tall and weighs 55 pounds. He follows a strict diet with only 1000 calories per day. Let us analyze his growth using a growth chart and compare it with other kids of the same age.

• From the growth chart, we can see that at 55 pounds, only 25% of children are at or below 55 pounds. For height ( 4 ft 3 inch = 51 inches) only 25% of children are at or below his height.

So overall, Jason falls among the 25% of children who have stunted growth.

• Jason has chronic renal failure or CKD. Let us see why renal failure stunts growth.
• The kidney is import organs involved in - a balance of nutrients and minerals such as calcium and phosphorous (Which are required for bone development), Kidney use the hormones calcitriol produced from vitamin D and balance the calcium absorption and its levels in the blood.
• Due to renal failure, vitamin D is not turned into calcitriol, stunting bone development. This increases the phosphorous levels in the blood which chelates calcium from the bone.
• Imbalance in salts due to renal failure creates undue stress to managing the osmotic and acid balance in the blood.
• Due to these conditions, appetite reduces further slowing the growth. Because of these factors CDK patients show stunted growth compared majority of (over 75%) of all children.