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Mouse Kidney Transplantation: Models of Allograft Rejection
Published on: October 11, 2014
Growth characterization in a cohort of renal allograft recipients
Mayerly Prada Rico1, Monica Fernandez Hernandez2, Marcela C Castellanos1
1Pediatric Nephrology Division, Pediatrics Department, Fundación Cardio-infantil, Bogotá, Cundinamarca, Colombia.
Insights
Children with chronic kidney disease (CKD) often experience growth retardation. Renal transplantation (RTx) showed limited catch-up growth, highlighting the need for early intervention to improve stature in pediatric patients.
Area of Science:
- Pediatric Nephrology
- Growth and Development
- Renal Transplantation
Background:
- Growth retardation is a significant challenge for children with chronic kidney disease (CKD).
- Assessing growth patterns before and after renal transplantation (RTx) is crucial for pediatric patients.
Purpose of the Study:
- To describe growth patterns in children undergoing RTx.
- To determine the prevalence of short stature before RTx.
- To evaluate catch-up growth post-RTx and identify associated factors.
Main Methods:
- Retrospective review of 74 pediatric renal allograft recipients.
- Analysis of pre-RTx and post-RTx height standard deviation scores (SDS).
- Comparison of demographic characteristics and factors associated with growth outcomes.
Main Results:
- 68.9% of patients had short stature before RTx, with 44.6% having severe short stature.
- Only 37.2% achieved catch-up growth within two years post-RTx.
- Longer time on dialysis was associated with shorter pre-RTx stature and less catch-up growth.
Conclusions:
- Growth remains suboptimal in many children after RTx.
- Pre-transplant height is a significant factor influencing post-transplant growth.
- Early interventions are essential to optimize growth in pediatric CKD patients awaiting or following RTx.
Introduction:
Growth retardation is a common problem in children with CKD. This study aims to describe growth, prevalence of short stature before RTx, catch-up growth after RTx, and associated factors.
Methods:
We retrospectively reviewed 74 renal allograft recipients who underwent RTx at Fundación Cardioinfantil, Colombia, between January 2008 and September 2016 with follow-up for 2 years afterwards. Pre-RTx Height_SDS and demographic characteristics were compared between children with normal and short stature. Post-RTx Height_SDS at 1 and 2 years post-RTx and FAH, when available, were retrieved. Children were classified into catch-up growth and no catch-up growth groups depending on whether or not Height_SDS increased ≥0.5 per year within the first 2 years post-RTx. Possible associated factors were compared.
Results:
Seventy-four patients were included. Mean age at RTx was 11 ± 4.0 years, and 43.2% (32/74) were females. Mean Height_SDS for the entire study population at pre-RTx was -2.8 ± 1.5. Before RTx, 68.9% (51/74) had short stature, and 44.6% (33/74) had severe short stature. 37.2% presented catch-up growth post-RTx. Time on dialysis was associated with short pre-RTx stature (OR 1.66; 95% CI [1.15-2.39]; P = .006) and catch-up growth (OR 2.15; 95% CI [1.15-3.99]; P = .016). 44.59% (33/74) reached FAH, and 48.4% (16/33) presented short FAH.
Conclusions:
Growth continues to be suboptimal after RTx. Given that pre-RTx height is a significantly associated factor, it is important to plan early interventions in terms of growth improvement in these children.
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