Related Experiment Video
Updated: Jul 6, 2026
Murine Kidney Transplant Technique
Published on: October 20, 2015
Growth after pediatric kidney transplantation: a 25-year study in a pediatric kidney transplant center
Ana Raquel Claro1, Ana Rita Oliveira2, Filipa Durão3,4
1Departamento de Pediatria, 218728 Hospital de Santa Maria - Centro Hospitalar Universitário de Lisboa Norte, EPE , Lisboa, Portugal.
Insights
Pediatric kidney transplant (KT) patients show catch-up growth, but final height remains suboptimal. Glomerular filtration rate (GFR) post-KT impacts growth, highlighting areas for improved post-transplant care strategies.
Area of Science:
- Pediatric Nephrology
- Transplantation Medicine
- Growth and Development
Background:
- Growth failure is a significant complication in pediatric chronic kidney disease (CKD).
- Up to 50% of children do not achieve their expected final height even after kidney transplant (KT).
Purpose of the Study:
- To assess longitudinal growth patterns in children following KT.
- To identify key factors influencing growth outcomes after pediatric KT.
Main Methods:
- Retrospective observational study of 149 pediatric patients undergoing KT over 25 years.
- Analysis of height and BMI z-scores at multiple time points pre- and post-KT, including transition to adult care.
- Evaluation of factors such as target height, dialysis history, growth hormone use, GFR, and corticosteroid dose.
Main Results:
- Patients demonstrated significant catch-up growth in height z-scores at 6 months, 1 year, 5 years post-KT, and at transition to adult care.
- Body Mass Index (BMI) z-scores also showed significant increases post-KT.
- Post-transplant Glomerular Filtration Rate (GFR) was significantly associated with both height and BMI z-scores.
Conclusions:
- While catch-up growth is observed post-KT, final height remains below target in many pediatric patients.
- Optimizing post-transplant GFR and other factors is crucial for improving final height outcomes in children after KT.
Objectives:
Growth failure is one of the major complications of pediatric chronic kidney disease. Even after a kidney transplant (KT), up to 50 % of patients fail to achieve the expected final height. This study aimed to assess longitudinal growth after KT and identify factors influencing it.
Methods:
A retrospective observational study was performed. We reviewed the clinical records of all patients who underwent KT for 25 years in a single center (n=149) and performed telephone interviews. Height-for-age and body mass index (BMI)-for-age were examined at KT, 3 months, 6 months, 1 year, and 5 years post-transplant and at the transition to adult care. We evaluated target height, disease duration before KT, need and type of dialysis, recombinant human growth hormone pretransplant use, nutritional support, glomerular filtration rate (GFR), and cumulative corticosteroid dose.
Results:
At transplant, the average height z-score was -1.38, and height z-scores showed catch-up growth at 6 months (z-score -1.26, p=0.006), 1 year (z-score -1.15, p<0.001), 5 years after KT (z-score -1.08, p<0.001), and on transition to adult care (z-score -1.22, p=0.012). Regarding BMI z-scores, a significant increase was also detected at all time points (p<0.001). After KT, GFR was significantly associated with height z-score (p=0.006) and BMI z-score (p=0.006). The height in transition to adult care was -1.28 SD compared to the target height.
Conclusions:
Despite the encouraging results regarding catch-up growth after KT in this cohort, results remain far from optimum, with a lower-than-expected height at the time of transition.
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