Abstract Objective To study the clinical features of catch-up growth of body height after kidney transplantation in children and related influencing factors. Methods A retrospective analysis was performed from the chart review data of 15 children who underwent kidney transplantation in Guangzhou Women and Children's Medical Center from July 2017 to November 2019. According to whether the increase in height standard deviation score (ΔHtSDS) in the first year after kidney transplantation reached ≥ 0.5, the children were divided into a catch-up group with 8 children and a non-catch-up group with 7 children. According to whether final HtSDS was ≥ -2, the children were divided into a standard group with 6 children and a non-standard group with 9 children. The features of catch-up growth of body height and related influencing factors were compared between groups. Results The data showed that median ΔHtSDS was 0.8 in the first year after transplantation, which suggested catch-up growth of body height. There was a significant difference in HtSDS between the non-catch-up and catch-up groups (P < 0.05). Baseline HtSDS before transplantation was positively correlated with HtSDS at the end of follow-up (r=0.622, P < 0.05) and was negatively correlated with △HtSDS in the first year after transplantation (r=-0.705, P < 0.05). Age of transplantation and mean dose of glucocorticoid (GC) per kg body weight were risk factors for catch-up growth after kidney transplantation (OR=1.23 and 1.74 respectively; P < 0.05), while baseline HtSDS and use of antihypertensive drugs were independent protective factors for catch-up growth (OR=0.08 and 0.18 respectively; P < 0.05); baseline HtSDS and ΔHtSDS in the first year after kidney transplantation were influencing factors for final HtSDS (β=0.984 and 1.271 respectively; P < 0.05). Conclusions Kidney transplantation should be performed for children as early as possible, growth retardation before transplantation should be improved as far as possible, and multiple treatment methods (including the use of GC and antihypertensive drugs) should be optimized after surgery, in order to help these children achieve an ideal body height.
Kumar G, Alismaili Z, Ilyas SH, et al. Good outcome of the single-center pediatric kidney transplant program in Abu Dhabi[J]. Pediatr Transplant, 2019, 23(7):e13566.
[3]
Smith JM, Stablein DM, Munoz R, et al. Contributions of the transplant registry:the 2006 annual report of the North American Pediatric Renal Trials and Collaborative Studies (NAPRTCS)[J]. Pediatr Transplant, 2007, 11(4):366-373.
[4]
Fine RN, Martz K, Stablein D. What have 20 years of data from the North American Pediatric Renal Transplant Cooperative Study taught us about growth following renal transplantation in infants, children, and adolescents with end-stage renal disease?[J]. Pediatr Nephrol, 2010, 25(4):739-746.
[5]
Abbud-Filho M, Adams PL, Alberú J, et al. A report of the Lisbon conference on the care of the kidney transplant recipient[J]. Transplantation, 2007, 83(8 Suppl):S1-S22.
[6]
Hermanussen M, Cole J. The calculation of target height reconsidered[J]. Horm Res, 2003, 59(4):180-183.
[7]
Phan V, Blydt-Hansen T, Feber J, et al. Skeletal findings in the first 12 months following initiation of glucocorticoid therapy for pediatric nephrotic syndrome[J]. Osteoporos Int, 2014, 25(2):627-637.
[8]
Curtis JR, Westfall AO, Allison J, et al. Population-based assessment of adverse events associated with long-term glucocorticoid use[J]. Arthritis Rheum, 2006, 55(3):420-426.
[9]
Al Nofal A, Bancos I, Benkhadra K, et al. Glucocorticoid replacement regimens in chronic adrenal insufficiency:a systematic review and meta-analysis[J]. Endocr Pract, 2017, 23(1):17-31.
[10]
Mehls O, Lindberg A, Nissel R, et al. Predicting the response to growth hormone treatment in short children with chronic kidney disease[J]. J Clin Endocrinol Metab, 2010, 95(2):686-692.
[11]
Harambat J, Cochat P. Growth after renal transplantation[J]. Pediatr Nephrol, 2009, 24(7):1297-1306.
[12]
Seikaly MG, Salhab N, Gipson D, et al. Stature in children with chronic kidney disease:analysis of NAPRTCS database[J]. Pediatr Nephrol, 2006, 21(6):793-799.
[13]
Alkadi MM, Kim J, Aull MJ, et al. Kidney allograft failure in the steroid-free immunosuppression era:a matched case-control study[J]. Clin Transplant, 2017, 31(11):e13117.
[14]
Aljebab F, Choonara I, Conroy S. Long-course oral corticosteroid toxicity in children[J]. Arch Dis Child, 2016, 101(9):e2.
[15]
Donatti TL, Koch VH, Takayama L, et al. Effects of glucocorticoids on growth and bone mineralization[J]. J Pediatr (Rio J), 2011, 87(1):4-12.
[16]
Dong F, Ren J. Insulin-like growth factors (IGFs) and IGF-binding proteins in nephrotic syndrome children on glucocorticoid[J]. Pharmacol Res, 2003, 48(4):319-323.
Klevebro S, Lundgren P, Hammar U, et al. Cohort study of growth patterns by gestational age in preterm infants developing morbidity[J]. BMJ Open, 2016, 6(11):e012872.
[19]
Netchine I, Azzi S, Le Bouc Y, et al. IGF1 molecular anomalies demonstrate its critical role in fetal, postnatal growth and brain development[J]. Best Pract Res Clin Endocrinol Metab, 2011, 25(1):181-190.
[20]
Vecchione C, Colella S, Fratta L, et al. Impaired insulin-like growth factor I vasorelaxant effects in hypertension[J]. Hypertension, 2001, 37(6):1480-1485.
[21]
Barros X, Fuster D, Rodríguez N, et al. Rapid calcitriol increase and persistent calcidiol insufficiency in the first 6 months after kidney transplantation[J]. Nucl Med Commun, 2015, 36(5):489-493.
[22]
Salević P, Radović P, Milić N, et al. Growth in children with chronic kidney disease:13 years follow up study[J]. J Nephrol, 2014, 27(5):537-544.
[23]
Stonebrook E, Mahan JD. Treatment of growth retardation in a child with CKD[J]. Clin J Am Soc Nephrol, 2019, 14(11):1658-1660.
[24]
Benfield MR, Kohaut EC. Growth hormone is safe in children after renal transplantation[J]. J Pediatr, 1997, 131(1 Pt 2):S28-S31.
[25]
Friedman AL. Growth hormone is not safe for children with renal transplants[J]. J Pediatr, 1997, 131(1 Pt 2):S25-S27.
[26]
Ulinski T, Cochat P. Longitudinal growth in children following kidney transplantation:from conservative to pharmacological strategies[J]. Pediatr Nephrol, 2006, 21(7):903-909.
[27]
Drube J, Wan M, Bonthuis M, et al. Clinical practice recommendations for growth hormone treatment in children with chronic kidney disease[J]. Nat Rev Nephrol, 2019, 15(9):577-589.
