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
Summary
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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