Growth impairment at renal transplantation--a determinant of growth and final height

Pediatr Transplant. 2003 Jun;7(3):192-9. doi: 10.1034/j.1399-3046.2003.00068.x.

Abstract

Long-term outcome of growth and final adult height (FH) are a major concern of children after a renal transplantation (Tx). We therefore studied the yearly measurements of height (Ht), expressed as the Z-score and bone age (BA), in 58 children (28 girls) transplanted in our departments and followed-up for 5-18 (mean 9.6) yr after the operation. Twenty-four children reached final adult height. Renal function was evaluated as the glomerular filtration rate (GFR), which is estimated from the clearance of inulin. The mean Ht Z-score at Tx was -1.3 in girls and -2.7 in boys and increased to -0.6 and -1.5, respectively, at 5 yr after Tx. The greatest increase, seen in the shortest children and those transplanted before 7 yr of age, occurred during the first 3 yr. Children aged 7-12 yr at Tx showed an increase in height during the first years after the transplant, while those transplanted at >12 yr of age were not growth-retarded and therefore did not change their Ht Z-score. The most growth-retarded were also the most BA retarded. The mean FH Z-score was -1.1. A direct correlation was seen between GFR at 1 yr after Tx and the increase in height Z-score from Tx to 1 and 5 yr after Tx. In summary, the increment in height following Tx was the greatest in the most growth-retarded children and most marked during the first 3 yr after the transplant. FH was within normal range in 75% of the children. A high Ht Z-score at Tx had a positive effect on FH. Thus, growth after Tx was affected by the degree of stunting at Tx and renal function after Tx.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Body Height*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Growth / physiology
  • Growth Disorders / etiology*
  • Growth Disorders / physiopathology
  • Humans
  • Kidney Transplantation* / physiology
  • Male
  • Puberty
  • Time Factors