Chronically uremic children seldom grow normally; growth while on extended hemodialysis is usually not adequate. In order to delineate more precisely the components of this growth failure and the changes in body composition with chronic dialysis, 46 simultaneous measurements of total body water and of extracellular water (ECW) were determined in 24 children aged 2–17 yrs. The data were divided into two groups: uremic children dialyzed 6 mos. Published data of Cheek for healthy children of similar age were used for comparison. In the uremic children body weight (BW) and height (Ht) were below normal for age. ECW was significantly higher in both groups for Ht and BW, and its fluctuations tended to confuse interpretation of weight changes. In both groups, cell mass (CM), derived from calculated intracellular water, was low in relation to BW and Ht. While on dialysis, Ht, BW, and CM tended to increase; CM as per cent BW did not change, and increases in CM with Ht were less rapid than in normals. Correlation between changes in CM with change in Ht was low. Nutritional status was a factor in rate of increase in CM and in Ht. Although normal linear growth velocity may be observed on dialysis, catch-up growth is uncommon. Growth occurred without restoration of the normal relationship of CM to Ht. These studies have proved useful in defining the character of body composition in uremic children and in evaluating changes in body composition in individual patients with time, variations in caloric intake, and with growth.
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