Linear Growth in Pediatric Kidney Transplant Population
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Updated: Nov 24, 2025
Murine Kidney Transplant Technique
Published on: October 20, 2015
Mercedes Lopez-Gonzalez1, Marina Munoz1, Victor Perez-Beltran1
1Department of Pediatric Nephrology, University Hospital Vall d'Hebron, Barcelona, Spain.
Insights
Pediatric kidney transplant recipients often have normal height at transplant and reach normal adult height. Younger children (<6 years) show the most significant growth catch-up post-transplant, with growth hormone therapy aiding height improvement.
Area of Science:
- Pediatric Nephrology
- Transplantation Medicine
- Growth and Development
Background:
- Growth retardation is a significant complication of pediatric chronic kidney disease (CKD).
- Impaired growth negatively impacts children's quality of life.
- Kidney transplantation (KT) is a treatment option for end-stage renal disease in children.
Purpose of the Study:
- To evaluate linear growth and final adult height in pediatric kidney transplant recipients.
- To identify factors influencing growth outcomes after KT.
- To assess the impact of recombinant human growth hormone (rhGH) therapy on growth.
Main Methods:
- Retrospective analysis of 95 pediatric patients (<18 years) undergoing their first KT between 2008-2018.
- Assessment of height standard deviation score (SDS) at KT and during follow-up.
- Multivariate analysis to identify predictors of growth.
- Review of rhGH treatment use before and after KT.
Main Results:
- Over half of patients had normal height at KT; over two-thirds achieved normal adult height.
- Linear growth improved post-transplant (from -1.53 to -1.37 SDS height).
- Children <3 years showed the greatest growth catch-up; older children did not.
- Corticosteroid use negatively impacted height SDS at 1 year and final height.
- rhGH treatment was administered to 44.2% pre-KT and 22.1% post-KT, improving height.
Conclusions:
- Pediatric KT recipients have favorable height outcomes, with a majority reaching normal adult height.
- Younger children (<6 years) experience significant growth catch-up after KT.
- rhGH therapy is associated with improved height in pediatric KT recipients.
Abstract:
Introduction: Growth retardation is one of the main complications of chronic kidney disease (CKD) in children and induces a negative impact on quality of life. Materials and Methods: Retrospective analysis of all consecutive patients younger than 18 years old who received a first KT in our center between 2008 and 2018. Results: 95 first KT recipients, median age at KT of 7.83 years. At the time of KT, 65.52% of males and 54.05% females showed normal height. After transplantation, linear growth improved from -1.53 at transplant to -1.37 SDS height at the last visit. We detected a different linear growth pattern according to patient age at KT. Children younger than 3 years old exhibited the most significant growth retardation at baseline and the greatest linear growth over time (-2.29 vs. -1.82 SDS height), whereas catch-up was not observed in older patients. Multivariate analysis showed that use of corticosteroids was negatively related to SDS height at 1 year after transplantation and final SDS height only was positively associated with SDS height at KT. 44.2 and 22.1% patients received rhGH treatment before and after KT. 71.88% patients reached adulthood with normal final height. Conclusions: In our study, pediatric KT recipients exhibited a normal height in more than half of cases at KT and in more than two thirds at the final adult height. Only children younger than 6 years old presented a relevant growth catch-up after KT. Treatment with rhGH was used before and after KT with significant improvement in height.
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