Growth monitoring is the bread and butter of general pediatric care. It becomes even more relevant in pediatric chronic kidney disease (CKD) given the high risk of growth failure in affected children. Ensuring appropriate growth is a difficult task for families and requires multidisciplinary support. Many underlying pathophysiological contributors to growth impairment in pediatric CKD, and medical approaches to their management, have been explored. However, it remains challenging to understand how to best support growth in this population in a way that makes the most tangible difference to the entire family’s quality of life.