Baseline height Z-score as an early marker of chronic kidney disease progression: insights from a two-year follow-up


Akay N., Aksu B., Yildirim Z. Y., Kardelen Al A. D., Nayir A., Yilmaz A.

PEDIATRIC NEPHROLOGY, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2026
  • Doi Number: 10.1007/s00467-026-07282-x
  • Journal Name: PEDIATRIC NEPHROLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Istanbul University-Cerrahpasa Affiliated: Yes

Abstract

BackgroundChronic kidney disease (CKD) in children is associated with substantial morbidity and risk of progression to kidney failure in some cases. Identifying clinical predictors of kidney function decline is essential for early intervention. This study evaluated demographic, clinical, and biochemical determinants of CKD progression in a pediatric cohort.MethodsThis retrospective study included 70 children with CKD stages 2-4 followed for at least two years at a tertiary pediatric nephrology center. CKD progression was defined as a >= 25% decline in estimated glomerular filtration rate (eGFR) over 24 months. Demographic, anthropometric, biochemical, and clinical parameters were assessed at baseline and during follow-up. Univariate and multivariate logistic regression analyses were performed to identify predictors of progression.ResultsCKD progression occurred in 41 of 70 patients (58.6%), and 17 (24.2%) developed kidney failure within two years. In univariate analyses, older age at follow-up was associated with increased progression risk (OR 1.008; p = 0.044), while longer CKD follow-up showed a borderline protective trend. Lower baseline calcium levels and first-year metabolic acidosis demonstrated clinically relevant but non-significant associations with progression. Baseline height Z-score remained the only independent predictor of CKD progression in multivariate analysis (OR 1.54; 95% CI 1.03-2.30; p = 0.034).ConclusionBaseline linear growth impairment represents an important anthropometric marker associated with accelerated CKD progression in children. Early growth assessment may aid risk stratification and support timely implementation of preventive strategies.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information