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Review
. 2009 Jul;24(7):1297-306.
doi: 10.1007/s00467-008-0787-0. Epub 2008 Mar 26.

Growth after renal transplantation

Jérôme Harambat  1 , Pierre Cochat
Affiliations
Review

Growth after renal transplantation

Jérôme Harambat et al. Pediatr Nephrol. 2009 Jul.

Abstract

Growth may be severely impaired in children with chronic renal insufficiency. Since short stature can have major consequences on quality of life and self-esteem, achieving a 'normal' height is a crucial issue for renal transplant recipients. However, despite successful renal transplantation, the final height attained by most recipients is not the calculated target height. Catch-up growth spurts post-transplantation are usually insufficient to compensate for the retardation in growth that has occurred during the pre-transplant period. Longitudinal growth post-transplantation is therefore influenced by the age at transplantation but also by subsequent allograft function and steroid exposure, both of which interfere with the growth hormone/insulin-like growth factor axis. The management of growth retardation in renal transplant recipients includes adequate nutritional intake, correction of metabolic acidosis, prevention of bone disease, steroid-sparing strategies and a supraphysiological dose of recombinant human growth hormone in selected cases.

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Figures

Fig. 1
Fig. 1
Mean changes (±SE) from baseline in height standard deviation score (SDS) by age at transplant (data from the NAPRTCS 2006 annual report)
See this image and copyright information in PMC

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