title: Effect of renal transplantation in childhood on longitudinal growth and adult height.
abstract: BACKGROUND
  Severe growth failure is frequently observed in children suffering from end-stage renal disease (ESRD).
  
  
  METHODS
  We analyzed the effect of renal transplantation (RTx) on longitudinal growth and final height in 37 children (19 girls) with ESRD with a mean follow-up of 8.5 years. The mean age at RTx was 11.3 years.
  
  
  RESULTS
  In children transplanted before start of puberty, mean height velocity increased significantly from 4.9 to 8.0 cm/year (P < 0.01), resulting in an increase in standardized height of 0.6 SD within two years post RTx. Although peak height velocity during puberty was significantly increased compared with healthy children, total pubertal height gain was reduced by 20% because of its shortened duration. Mean standardized height significantly increased from the time of RTx until final height by 1.3 SD and 0.7 SD in children transplanted before and after start of puberty, respectively. Mean adult height (boys 170 cm; girls 151 cm) was normal (> -2 SD) in 68% of patients. Change in standardized height from RTx until adult height was associated with initial degree of stunting and glomerular filtration rate (GFR; cumulative r2 0.49). Total pubertal height gain was associated with the age at start of puberty, GFR, and age at RTx (cumulative r2 0.57).
  
  
  CONCLUSIONS
  RTx in children with ESRD induces moderate catch-up growth during the prepubertal growth period. However, final height is reduced in about one third of patients due to the reduced pubertal height gain and preexisting height deficit at the time of RTx.
authors.affiliation: Department of Pediatric Nephrology, Charité Children's Hospital, Humboldt University, Berlin, Germany.
authors.forename: Richard
authors.initials: R
authors.lastname: Nissel
authors.forename: Ira
authors.initials: I
authors.lastname: Brázda
authors.forename: Reinhard
authors.initials: R
authors.lastname: Feneberg
authors.forename: Marianne
authors.initials: M
authors.lastname: Wigger
authors.forename: Christel
authors.initials: C
authors.lastname: Greiner
authors.forename: Uwe
authors.initials: U
authors.lastname: Querfeld
authors.forename: Dieter
authors.initials: D
authors.lastname: Haffner
mesh_terms: D000293:Adolescent; D001827:Body Height; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D006130:Growth Disorders / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D011627:Puberty