Evaluation of growth in children and adolescents after renal transplantation

Özet

Despite the advances in the last decades, it is well-known that optimalgrowth is usually not achieved in children with chronic kidney disease (CKD)even after successful renal transplantation (RTx). In this study, our aim wasto evaluate growth patterns and factors affecting growth in pediatric andadolescent renal transplant recipients (RTR). Thirty-seven prevalent RTR withmean age of 17.0±2.9 years and mean post-RTx duration of 4.2±2.0 yearswere evaluated. Growth parameters, height velocities and factors affectinggrowth at the time of RTx (baseline) and in the post-RTx follow-up werealso retrospectively assessed. Cumulative corticosteroid (CS) doses werecalculated. Mean height and weight standard deviation score (SDS) valueswere negative (-1.4±1.1 and -1.2±1.5, respectively), whereas height SDSwas positive in 16% of the patients. Mean weight, height, and BMI (bodymass index) SDS of the RTR were significantly higher than the values attransplantation (p<0.001 for weight and height SDS; p<0.05 for BMI SDS).Height SDS was <-2.0 in 19% of the patients while 60% at the baseline.Main factors associated with post-RTx height SDS were pre-RTx height SDS(B: 0.448, p<0.01) and CKD duration (B: -0.01, p<0.05). Although it wasmuch better than the pre-RTx period, the present study reveals that postRTx growth was less than anticipated. As well as minimizing post-RTx CSdoses and preserving graft function in the post-RTx follow-up, performingearly transplantation and all efforts for minimizing pre-RTx growth deficitare crucial for an optimal post-RTx growth.