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Abstract Thirty children with chronic renal insufficiency (estimated GFR < 50 % of that expected for age ) due to congenital renal disease were prospectively studied by assessing: 1- Renal function by measuring the glomerular filtration rate. 2- Nutritional status using the weiqhtjheight ratio ( Waterlow, 1972 ). 3- Growth status by measuring the length or height standard deviation scores (LSDs) and head circumference standard deviation score (HCSDs). 4- Developmental status using the Bayley Scales of Infant Development (Bayley, 1969 ). The mean age of the children at the time of their first evaluation was 1.19 + 0.53 years ( range 0.2 to 2 years )and the mean age of the children at the time of their second evaluation was 1.63 + 0.58 years (range of 0.5 to 2.5 years). These measurements allowed us to test the hypothesis that growth retardation and developmental delay observed so commonly in young children with renal insufficiency were related either to the severity of renal impairment or to the nutritional deprivation. The developmental level achieved was significantly related to the children’s growth and to the severity of their renal impairment. We also found a strong correlation between the developmental level achieved at first and second evaluations. However, the correlation between the developmental scores and nutritional state was weak. The most striking correlation observed was that between the developmental scores at first and second evaluations. It suggests that little change in neurodevelopmental status can be anticipated throughout time. Seventeen patients maintained a MDI above 84 (-lSD) at their second evaluation comprised group 1. The remaining 13 patients had a MDI less than 84 at their second evaluation comprised group 2 . Group 2 patients had smaller length or height (P < 0.01 ) and head circumference (P < 0.01 ) standard deviation scores in comparison with group one, and they had lower glomerular filtration rates (P < 0.01 ). There was insignificant difference in the nutritional status between group 1 and group 2 ( P > 0.05 ). We concluded that the developing nervous system and growth of infants and young children may be particularly sensitive to the effects of chronic azotemia and that the nutritional deprivation is not the only cause for developmental delay in children with chronic renal failure. |