title: Factors affecting growth and final adult height after pediatric renal transplantation.
abstract: BACKGROUND
  Growth retardation is a common problem for children with chronic kidney disease. Although renal transplantation (RTx) resolves endocrine metabolic and uremic disturbances, growth continues to be suboptimal. This study aims to describe changes in height from diagnosis to final adult height (FAH) in Korean renal allograft recipients and determine factors associated with posttransplantation growth.
  
  
  METHODS
  We retrospectively reviewed 63 renal allograft recipients who underwent RTx at <15 years of age with regular follow-up for >3 years afterwards. Pre- and post-RTx growth was analyzed by height Z scores (Ht_Z) at RTx, 2 and 5 years follow-up, and at FAH.
  
  
  RESULTS
  Ht_Z decreased from diagnosis to dialysis by -0.8 (P = .009) and from dialysis to RTx by -0.46 (P < .001). The mean baseline Ht_Z at RTx was -1.62 ± 1.36. The change in Ht_Z at 2 and 5 years after transplantation was 0.68 ± 0.88 and 0.48 ± 0.86, respectively. Both variables were negatively correlated with baseline age at RTx. Mean FAH was -1.22 ± 1.11 and was positively correlated with baseline height at RTx. Height at start of dialysis and dialysis duration were significant determinants of baseline height at RTx (P < .001).
  
  
  CONCLUSIONS
  Although there is significant posttransplant catch-up growth among younger recipients and among those with greater baseline height deficit, catch-up growth is not sustained and greater FAH is attained in those who are taller at RTx. Achieving greater height before dialysis and decreasing dialysis duration leads to maximal height at RTx as well as greater FAH.
authors: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
authors: H W
authors: HW
authors: Jung
authors: H Y
authors: HY
authors: Kim
authors: Y A
authors: YA
authors: Lee
authors: H G
authors: HG
authors: Kang
authors: C H
authors: CH
authors: Shin
authors: I S
authors: IS
authors: Ha
authors: H I
authors: HI
authors: Cheong
authors: S W
authors: SW
authors: Yang
mesh_terms: D000293:Adolescent; D001827:Body Height; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D004703:Endocrine System; D005260:Female; D006130:Growth Disorders / Q000209:etiology; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000379:methods*; D007723:Korea; D016014:Linear Models; D008297:Male; D011184:Postoperative Period; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D014184:Transplantation, Homologous