PEW was an independent predictor of impaired height velocity after adjusting for confounders (<i>β</i> = -0.32, <i>P</i> < 0.001); hs-CRP levels were positively correlated with PEW scores (<i>r</i> = 0.41, <i>P</i> < 0.001), and elevated hs-CRP (>3 mg/L) was an independent risk factor for PEW (OR = 2.86, 95% CI: 1.52-5.38, <i>P</i> = 0.001).<h4>Conclusion</h4>PEW is highly prevalent in advanced pediatric CKD, driven by inflammation and nutritional deficits, and acts as an independent predictor of growth retardation. This evidence concerns the gene CRP and chronic kidney disease.