Adult Height Achieved in Children After Kidney Transplantation

Aschendorff, C.

doi:10.1001/archpedi.1990.02150340084029

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…Growth impairment seems not to be caused primarily by the metabolic defect itself but rather by the early tubular lesions and the progressive loss of renal function, since growth after restoration of renal function by kidney transplantation improved impressively. Posttransplantational growth rates were indeed at least as good in cystinotic as in non-cystinotic patients under the same type of immunosuppression [2,7,12,14,23,24]. This indicates that growth retardation in cystinosis should be treated early and in the same way as in other chronic renal diseases [19,20].…”

Section: Discussionmentioning

confidence: 77%

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Growth and pubertal development in nephropathic cystinosis

et al. 1993

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In a retrospective investigation growth and pubertal development were evaluated in 30 patients with nephropathic cystinosis. Growth was investigated during the stage of chronic renal insufficiency as well as after successful kidney transplantation and growth rates were related to kidney function. Pubertal development was evaluated in 17 patients between 12 and 25 years of age. Prepubertal growth rates were stable in a range between -2 and -3 height velocity SDS as long as glomerular filtration rate was above 20ml/min per 1.73m2. A decrease in glomerular filtration rate below this threshold was followed by further decrease in height velocity. After kidney transplantation a significant catch-up growth was seen if immunosuppression was performed with cyclosporine A and low dose prednisolone. This did not occur if conventional therapy with azathioprine and high-dose prednisolone was used. Onset of puberty was delayed in all patients. Gonadotropin and oestradiol levels in female patients showed normal fluctuations according to ovulatory cycles. In male patients after puberty there was an increase in gonadotropin levels above the normal range for adult men while testosterone levels remained in the low normal range. These results indicate that adult men with nephropathic cystinosis may develop hypergonadotropic hypogonadism.

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Section: Discussionmentioning

confidence: 77%

“…Although growth is retarded in most children with chronic renal insufficiency even after kidney transplantation [2,3,6,7,12,23,25,29] it appears to be particularly severe in cystinotic patients.…”

Section: Introductionmentioning

confidence: 99%

Growth and pubertal development in nephropathic cystinosis

et al. 1993

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“…Median difference between final height and target height was 15.0 cm for males and 15.4 cm for females. Aschendorff et al (25) also reported that the target height for nine patients treated with CyA and low-dose prednisolone could not be achieved. The difference between final height and target height was 4 cm for males and 7 cm for females.…”

Section: Discussionmentioning

confidence: 99%

A prospective trial of steroid withdrawal after renal transplantation treated with cyclosporine and mizoribine in children: Results obtained between 1990 and 2003

Motoyama

Hasegawa

Ohara

et al. 2005

Pediatric Transplantation

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A prospective trial of adrenocorticostertoid (steroid) withdrawal after pediatric renal transplantation was begun in 1990. Ninety-four pediatric renal transplant recipients were enrolled in our multicenter study. Immunosuppressive therapy with cyclosporine (CyA), methylprednisolone (MPL), and mizoribine (MZ) was started after transplantation. MPL was reduced to administration on alternate days in 69 patients (73.4%) and was withdrawn in 27 patients (28.7%). Rejection episodes occurred in nine patients (33.3%) after withdrawal of MPL. It occurred within 3 months after withdrawal of MPL in two patients and more than 6 months in the others. Among them, two patients lost the grafts. Thirteen-year patient survival rate and graft survival rate were 94.6 and 83.1%, respectively. Forty-four of the 94 patients reached their final height. Mean final height was 155.0 cm in males and 146.3 cm in females and their height standard deviation score was -2.6 s.d., the same as that at the time of transplantation. Management of growth retardation before transplantation and further reduction in the steroid dose after transplantation will increase the final height of children with chronic renal failure.

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“…In the fourth study (IV), performed in 1989 [26], the final adult height of 20 transplant recipients was analysed and compared with the target height and the predicted height at time of transplantation. Eleven patients received Aza and 9 patients CyA.…”

Section: Methodsmentioning

confidence: 99%

Growth after renal transplantation: an update

1991

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Several factors influencing post-transplant growth were analysed in a total of 163 children receiving transplants at the Medical School Hannover. Statural height at the time of transplantation depended on the length of the pre-transplant period of chronic renal failure, and was more retarded in children with congenital renal diseases than in those with acquired diseases. The retardation of bone age correlated significantly with the degree of growth retardation. The immunosuppressive regimen of cyclosporine A (CyA) and low-dose prednisolone was followed by significantly better growth rates than azathioprine (Aza) plus high-dose prednisolone. In 22 prepubertal children receiving CyA, poor graft function with a glomerular filtration rate below 40 ml/min per 1.73 m2 inhibited catch-up growth. The final height of 20 grown-up transplant recipients was found to be in the lower range of normal. A comparison of conventional and CyA treatment showed that adult height in the CyA group was higher than in the Aza group due to a significantly higher growth velocity.

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Adult Height Achieved in Children After Kidney Transplantation

Cited by 10 publications

References 14 publications

Growth and pubertal development in nephropathic cystinosis

Growth and pubertal development in nephropathic cystinosis

A prospective trial of steroid withdrawal after renal transplantation treated with cyclosporine and mizoribine in children: Results obtained between 1990 and 2003

Growth after renal transplantation: an update

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