Growth after renal transplantation: an update

Offner, G.; Aschendorff, C.; Brodehl, J.

doi:10.1007/bf01453684

Cited by 24 publications

(10 citation statements)

References 27 publications

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“…This indicates that growth retardation in cystinosis should be treated early and in the same way as in other chronic renal diseases [19,20]. Since final height is correlated with duration of chronic renal failure and growth retardation before transplantation [25], it is important to treat growth retardation as early as possible.…”

Section: Discussionmentioning

confidence: 99%

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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: 99%

“…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: 97%

Growth and pubertal development in nephropathic cystinosis

et al. 1993

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“…Reduced allograft function impairs growth in CRF and after TX [7,[27][28][29]. In many earlier reports, "catchdown" growth was seen a few years after TX.…”

Section: Growth Hormone Therapymentioning

confidence: 99%

Growth after renal transplantation in infancy or early childhood

Qvist¹,

Marttinen

Rönnholm³

et al. 2002

Pediatr Nephrol

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Forty-one children <5 years of age at kidney transplantation (TX) were investigated for growth, bone age, and renal function up to 7 years ( n=26) after TX. All children received triple immunosuppression, including alternate-day corticosteroid treatment. Catch-up growth was seen in 81% of 30 children without growth hormone (GH) treatment. Children <2 years of age without GH had a mean height standard deviation score (hSDS) of -1.1+/-0.8 at TX and -1.1+/-0.5 at 7 years; children between 2 and 5 years improved their hSDS from -1.9+/-0.9 to -0.4+/-0.8 ( P<0.0001). The hSDS at TX correlated inversely with the DeltahSDS from TX to 7 years ( r=-0.80, P=0.0002). Glomerular filtrations rate (GFR) at 5 years post TX correlated with the subsequent growth rate from 5 to 7 years TX ( r=0.58, P=0.01). Catch-up growth was seen in all 11 children receiving GH. Their mean hSDS improved from -2.5+/-0.9 to -1.1+/-0.9 ( P<0.0001). In the majority of children receiving a kidney graft in early life, triple immunosuppression with alternate-day steroids can ensure catch-up growth. In children <5 years of age at TX, growth is predicted better by the degree of stunting than by age.

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“…Catch-up growth is observed during remission of nephrotic syndrome and discontinuation of glucocorticoids [7,8]. In children with chronic renal failure, the amount of catch-up growth following transplantation appears to depend on age and on the post-transplantation dose of glucocorticoid administered [9,10,11,12].…”

Section: Introductionmentioning

confidence: 98%

Catch-up growth: possible mechanisms

Gafni

Baron

2000

Pediatric Nephrology

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Many systemic diseases impair linear growth. If remission occurs, growth will often accelerate beyond the normal rate for age, a phenomenon termed "catch-up growth." As a result, final height is improved, although this recovery of adult stature is frequently incomplete. Two principal models have been proposed to explain catch-up growth. The first model postulates a central nervous system mechanism that compares actual body size with an age-appropriate set-point and then adjusts growth rate accordingly. However, there is recent evidence that growth inhibition in a single growth plate is followed by local catch-up growth, a finding not readily explained by the neuroendocrine model. Thus, a new model has been proposed that places the mechanism within the growth plate itself. According to this model, growth-inhibiting conditions decrease proliferation of growth plate stem cells, thus conserving their proliferative potential. Additional research is needed to determine whether the mechanisms governing catch-up growth are local, systemic, or both.

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Growth after renal transplantation: an update

Cited by 24 publications

References 27 publications

Growth and pubertal development in nephropathic cystinosis

Growth and pubertal development in nephropathic cystinosis

Growth after renal transplantation in infancy or early childhood

Catch-up growth: possible mechanisms

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