Marjolein Bonthuis1, Jaap W Groothoff2, Gema Ariceta3, Sergey Baiko4, Nina Battelino5, Anna Bjerre6, Karlien Cransberg7, Gabriel Kolvek8, Heather Maxwell9, Polina Miteva10, Maria S Molchanova11, Thomas J Neuhaus12, Lars Pape13, Gyorgy Reusz14, Caroline Rousset-Rouviere15, Ana Rita Sandes16, Rezan Topaloglu17, Maria Van Dyck18, Elisa Ylinen19, Ilona Zagozdzon20, Kitty J Jager1, Jérôme Harambat21. 1. ESPN/ERA-EDTA Registry, Department of Medical Informatics, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 2. Department of Pediatric Nephrology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. 3. Pediatric Nephrology Department, Hospital Universitari Vall d'Hébron, Universitat Autónoma de Barcelona, Barcelona, Spain. 4. Department of Pediatrics, Belarusian State Medical University, Minsk, Belarus. 5. Department of Pediatric Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia. 6. Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway. 7. Department of Pediatric Nephrology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands. 8. Paediatric Department, Faculty of Medicine, Safarik University, Kosice, Slovakia. 9. Department of Paediatric Nephrology, Royal Hospital for Children, Glasgow, United Kingdom. 10. University Hospital for Active Treatment of Pediatric Diseases, Sofia Medical University, Sofia, Bulgaria. 11. Pirogov Russian National Research Medical University, Moscow, Russia. 12. Children's Hospital Lucerne, Lucerne, Switzerland. 13. Department of Pediatric Nephrology, Hannover Medical School, Hannover, Germany. 14. Department of Pediatrics, Semmelweis University, Budapest, Hungary. 15. Unité de Néphrologie Pédiatrique, Hôpital La Timone, AP-HM, Université de la Méditerranée, Marseille, France. 16. Nephrology and Transplantation Unit, Department of Paediatrics, Santa Maria Hospital, Academic Center, Lisbon, Portugal. 17. Department of Pediatric Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey. 18. Department of Pediatric Nephrology and Growth and Regeneration, University Hospitals Leuven, KU Leuven, Leuven, Belgium. 19. Department of Pediatric Nephrology and Transplantation, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland. 20. Department Paediatrics, Nephrology and Hypertension, Medical University of Gdansk, Gdansk, Poland. 21. Pediatric Nephrology Unit, Bordeaux University Hospital, Bordeaux, France.
Abstract
BACKGROUND: Improved management of growth impairment might have resulted in less growth retardation after pediatric kidney transplantation (KT) over time. We aimed to analyze recent longitudinal growth data after KT in comparison to previous eras, its determinants, and the association with transplant outcome in a large cohort of transplanted children using data from the European Society for Paediatric Nephrology/European Renal Association and European Dialysis and Transplant Association Registry. METHODS: A total of 3492 patients transplanted before 18 years from 1990 to 2012 were included. Height SD scores (SDS) were calculated using recent national or European growth charts. We used generalized equation models to estimate the prevalence of growth deficit and linear mixed models to calculate adjusted mean height SDS. RESULTS: Mean adjusted height post-KT was -1.77 SDS. Height SDS was within normal range in 55%, whereas 28% showed moderate, and 17% severe growth deficit. Girls were significantly shorter than boys, but catch-up growth by 5 years post-KT was observed in both boys and girls. Children <6 years were shortest at KT and showed the greatest increase in height, whereas there was no catch-up growth in children transplanted >12. CONCLUSIONS: Catch-up growth post-KT remains limited, height SDS did not improve over time, resulting in short stature in nearly half of transplanted children in Europe.
BACKGROUND: Improved management of growth impairment might have resulted in less growth retardation after pediatric kidney transplantation (KT) over time. We aimed to analyze recent longitudinal growth data after KT in comparison to previous eras, its determinants, and the association with transplant outcome in a large cohort of transplanted children using data from the European Society for Paediatric Nephrology/European Renal Association and European Dialysis and Transplant Association Registry. METHODS: A total of 3492 patients transplanted before 18 years from 1990 to 2012 were included. Height SD scores (SDS) were calculated using recent national or European growth charts. We used generalized equation models to estimate the prevalence of growth deficit and linear mixed models to calculate adjusted mean height SDS. RESULTS: Mean adjusted height post-KT was -1.77 SDS. Height SDS was within normal range in 55%, whereas 28% showed moderate, and 17% severe growth deficit. Girls were significantly shorter than boys, but catch-up growth by 5 years post-KT was observed in both boys and girls. Children <6 years were shortest at KT and showed the greatest increase in height, whereas there was no catch-up growth in children transplanted >12. CONCLUSIONS: Catch-up growth post-KT remains limited, height SDS did not improve over time, resulting in short stature in nearly half of transplanted children in Europe.
Authors: Theodore Vassilikopoulos; Athena Kalokairinou; Georgia Kourlaba; Eirini Grapsa Journal: Int J Environ Res Public Health Date: 2021-12-04 Impact factor: 3.390