Factors affecting growth and final adult height after pediatric renal transplantation

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Abstract

Background: Growth retardation is a common problem for children with chronic kidney disease. Although renal transplantation (RTx) resolves endocrine metabolic and uremic disturbances, growth continues to be suboptimal. This study aims to describe changes in height from diagnosis to final adult height (FAH) in Korean renal allograft recipients and determine factors associated with posttransplantation growth. Methods: We retrospectively reviewed 63 renal allograft recipients who underwent RTx at <15 years of age with regular follow-up for >3 years afterwards. Pre- and post-RTx growth was analyzed by height Z scores (Ht-Z) at RTx, 2 and 5 years follow-up, and at FAH. Results: Ht-Z decreased from diagnosis to dialysis by -0.8 (P =.009) and from dialysis to RTx by -0.46 (P <.001). The mean baseline Ht-Z at RTx was -1.62 ± 1.36. The change in Ht-Z at 2 and 5 years after transplantation was 0.68 ± 0.88 and 0.48 ± 0.86, respectively. Both variables were negatively correlated with baseline age at RTx. Mean FAH was -1.22 ± 1.11 and was positively correlated with baseline height at RTx. Height at start of dialysis and dialysis duration were significant determinants of baseline height at RTx (P <.001). Conclusions: Although there is significant posttransplant catch-up growth among younger recipients and among those with greater baseline height deficit, catch-up growth is not sustained and greater FAH is attained in those who are taller at RTx. Achieving greater height before dialysis and decreasing dialysis duration leads to maximal height at RTx as well as greater FAH.

Original languageEnglish
Pages (from-to)108-114
Number of pages7
JournalTransplantation Proceedings
Volume45
Issue number1
DOIs
StatePublished - Jan 2013

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