Abstract

Introduction: Growth retardation is one of the main complications of chronic kidney disease (CKD) in children and induces a negative impact on quality of life.Materials and Methods: Retrospective analysis of all consecutive patients younger than 18 years old who received a first KT in our center between 2008 and 2018.Results: 95 first KT recipients, median age at KT of 7.83 years. At the time of KT, 65.52% of males and 54.05% females showed normal height. After transplantation, linear growth improved from −1.53 at transplant to −1.37 SDS height at the last visit. We detected a different linear growth pattern according to patient age at KT. Children younger than 3 years old exhibited the most significant growth retardation at baseline and the greatest linear growth over time (−2.29 vs. −1.82 SDS height), whereas catch-up was not observed in older patients. Multivariate analysis showed that use of corticosteroids was negatively related to SDS height at 1 year after transplantation and final SDS height only was positively associated with SDS height at KT. 44.2 and 22.1% patients received rhGH treatment before and after KT. 71.88% patients reached adulthood with normal final height.Conclusions: In our study, pediatric KT recipients exhibited a normal height in more than half of cases at KT and in more than two thirds at the final adult height. Only children younger than 6 years old presented a relevant growth catch-up after KT. Treatment with rhGH was used before and after KT with significant improvement in height.

Highlights

  • Growth retardation is one of the main complications of chronic kidney disease (CKD) in children and induces a negative impact on quality of life

  • According to the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS) and the European Society for Pediatric Nephrology/European Renal Association and European Dialysis and Transplant Association (ESPN/ERA-EDTA), only about half of the patients receiving a kidney transplant (KT) during childhood reach an adult normal height (SDS >1.88) despite observed improvement in impaired growth management during the last decades [3, 4]

  • Our aim is to describe the observed growth pattern in a series of pediatric patients who received a KT in our center and to evaluate what factors are associated with patient height, comparing our results with gathered data from large population-based pediatric KT recipient registers

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Summary

Introduction

Growth retardation is one of the main complications of chronic kidney disease (CKD) in children and induces a negative impact on quality of life. Growth retardation is one of the main complications of chronic kidney disease (CKD) in children [1, 2]. Even KT being the best renal replacement therapy (RRT) modality, its contribution to final height and growth normalization in pediatrics is limited [5]. Growth retardation in transplanted children and adolescents overall reflects worse patient clinical status and often is associated with poor medical outcome [6]. Growth delay induces a negative impact on quality of life (QoL) and social conditions and is linked to a lower level of education and employment. 36% of them were not pleased to it [7,8,9]

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