BACKGROUND: Achieving a normal final adult height (FH) remains a challenge in the field of pediatric kidney transplantation (KTx). To examine the optimal approach to assuring normal FH following KTx, we retrospectively examined the post-transplant growth and FH of pediatric KTx recipients. METHODS: Since the relevant factors affecting the FH of children following KTx are multifactorial and notably complex, KTx recipients with persistent good graft function and successful steroid minimization until FH attainment were selected for this study. RESULTS: Thirteen patients were enrolled in this study. The mean estimated glomerular filtration rate was 72.1 ± 15.3 ml/min/1.73 m(2), and the mean corticosteroid dose was 0.05 ± 0.05 mg/kg on alternate days at the time of FH attainment. Despite highly successful KTx, four (30.8 %) patients (one who underwent KTx before puberty and three during puberty) showed a decrease in the height standard deviation score (hSDS) from the time of KTx until FH attainment. Moreover, of these, two male patients had an FH with an SD <-2. CONCLUSION: FH remained suboptimal despite highly successful KTx. Not only highly successful KTx but also further treatment such as steroid avoidance, early steroid withdrawal or using rhGH might be necessary to assure a normal FH in some pubertal patients.
BACKGROUND: Achieving a normal final adult height (FH) remains a challenge in the field of pediatric kidney transplantation (KTx). To examine the optimal approach to assuring normal FH following KTx, we retrospectively examined the post-transplant growth and FH of pediatric KTx recipients. METHODS: Since the relevant factors affecting the FH of children following KTx are multifactorial and notably complex, KTx recipients with persistent good graft function and successful steroid minimization until FH attainment were selected for this study. RESULTS: Thirteen patients were enrolled in this study. The mean estimated glomerular filtration rate was 72.1 ± 15.3 ml/min/1.73 m(2), and the mean corticosteroid dose was 0.05 ± 0.05 mg/kg on alternate days at the time of FH attainment. Despite highly successful KTx, four (30.8 %) patients (one who underwent KTx before puberty and three during puberty) showed a decrease in the height standard deviation score (hSDS) from the time of KTx until FH attainment. Moreover, of these, two male patients had an FH with an SD <-2. CONCLUSION: FH remained suboptimal despite highly successful KTx. Not only highly successful KTx but also further treatment such as steroid avoidance, early steroid withdrawal or using rhGH might be necessary to assure a normal FH in some pubertal patients.
Authors: A C Hokken-Koelega; M A van Zaal; W van Bergen; M A de Ridder; T Stijnen; E D Wolff; R C de Jong; R A Donckerwolcke; S M de Muinck Keizer-Schrama; S L Drop Journal: Pediatr Res Date: 1994-09 Impact factor: 3.756
Authors: R Grenda; A Watson; R Trompeter; B Tönshoff; J Jaray; M Fitzpatrick; L Murer; K Vondrak; H Maxwell; R Van Damme-Lombaerts; C Loirat; E Mor; P Cochat; D V Milford; M Brown; N J A Webb Journal: Am J Transplant Date: 2010-04 Impact factor: 8.086
Authors: Angela Delucchi; Marcela Valenzuela; Ana M Lillo; Jose Luis Guerrero; Francisco Cano; Marta Azocar; Pedro Zambrano; Paulina Salas; Viola Pinto; Mario Ferrario; Jorge Rodríguez; Gabriel Cavada Journal: Pediatr Nephrol Date: 2011-06-22 Impact factor: 3.714
Authors: A C Hokken-Koelega; T Stijnen; M A de Ridder; S M de Muinck Keizer-Schrama; E D Wolff; M C de Jong; R A Donckerwolcke; J W Groothoff; W F Blum; S L Drop Journal: Lancet Date: 1994-05-28 Impact factor: 79.321