Growth after renal transplantation in infancy or early childhood.
Forty-one children <5 years of age at kidney transplantation (TX) were investigated for growth, bone age, and renal function up to 7 years ( n=26) after TX. All children received triple immunosuppression, including alternate-day corticosteroid treatment. Catch-up growth was seen in 81% of 30 children without growth hormone (GH) treatment. Children <2 years of age without GH had a mean height standard deviation score (hSDS) of -1.1+/-0.8 at TX and -1.1+/-0.5 at 7 years; children between 2 and 5 years improved their hSDS from -1.9+/-0.9 to -0.4+/-0.8 ( P<0.0001). The hSDS at TX correlated inversely with the DeltahSDS from TX to 7 years ( r=-0.80, P=0.0002). Glomerular filtrations rate (GFR) at 5 years post TX correlated with the subsequent growth rate from 5 to 7 years TX ( r=0.58, P=0.01). Catch-up growth was seen in all 11 children receiving GH. Their mean hSDS improved from -2.5+/-0.9 to -1.1+/-0.9 ( P<0.0001). In the majority of children receiving a kidney graft in early life, triple immunosuppression with alternate-day steroids can ensure catch-up growth. In children <5 years of age at TX, growth is predicted better by the degree of stunting than by age.
Qvist
Erik
E
Pediatric Nephrology and Transplantation, Hospital for Children and Adolescents, University of Helsinki, Stenbäckinkatu 11, 00290 Finland. erik.qvist@helsinki.fi
Marttinen
Eino
E
Rönnholm
Kai
K
Antikainen
Marjatta
M
Jalanko
Hannu
H
Sipilä
Ilkka
I
Holmberg
Christer
C
D000365:Age Determination by Skeleton; D001827:Body Height; D001835:Body Weight; D002675:Child, Preschool; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D013006:Growth Hormone / Q000627:therapeutic use; D006801:Humans; D007668:Kidney / Q000254:growth & development* / Q000503:physiopathology; D016030:Kidney Transplantation; D008297:Male
D013006:Growth Hormone