Kidney transplanted children come of age

Offner, G.; Latta, Kay; Hoyer, Peter F.; Baum, Hans-Jürgen; Ehrich, J. H. H.; Pichlmayr, R.; Brodehl, J.

doi:10.1046/j.1523-1755.1999.00356.x

Cited by 145 publications

(117 citation statements)

References 34 publications

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“…We found CsA to impact significantly and independently both on early and long term graft survival. This is similar to the findings of two single center pediatric studies (Chavers et al, 1994;Offner et al, 1999) reporting a beneficial effect of CsA up to 5 and 8 years post-transplant. The introduction of CsA in the mid-1980s for the prevention of acute rejection has been a major breakthrough in the transplantation field.…”

Section: Discussionsupporting

confidence: 89%

Factors Related to Graft Outcome in Pediatric Renal Transplantation: a Single Center Study

Herman¹,

Damme‐Lombaerts²

2011

After the Kidney Transplant - The Patients and Their Allograft

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Section: Discussionsupporting

confidence: 89%

Factors Related to Graft Outcome in Pediatric Renal Transplantation: a Single Center Study

Herman¹,

Damme‐Lombaerts²

2011

After the Kidney Transplant - The Patients and Their Allograft

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“…In recent years, several single-center reports have specifically addressed final height after transplantation in childhood (9)(10)(11)(12)(13). The proportion of patients who achieved a final height within the normal range ranged from 47% to 75%, which appears considerably improved over early reports in which normal adult height was achieved in only 23%-38% (14,15).…”

Section: Introductionmentioning

confidence: 97%

Adult Height in Patients with Advanced CKD Requiring Renal Replacement Therapy during Childhood

Harambat¹,

Bonthuis²,

Stralen

et al. 2014

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Growth and final height are of major concern in children with ESRD. This study sought to describe the distribution of adult height of patients who started renal replacement therapy (RRT) during childhood and to identify determinants of final height in a large cohort of RRT children.Design, setting, participants, & measurements A total of 1612 patients from 20 European countries who started RRT before 19 years of age and reached final height between 1990 and 2011 were included. Linear regression analyses were performed to calculate adjusted mean final height SD score (SDS) and to investigate its potential determinants.Results The median final height SDS was 21.65 (median of 168 cm in boys and 155 cm in girls). Fifty-five percent of patients attained an adult height within the normal range. Adjusted for age at start of RRT and primary renal diseases, final height increased significantly over time from 22.06 SDS in children who reached adulthood in 1990-1995 to 21.33 SDS among those reaching adulthood in 2006-2011. Older age at start of RRT, more recent period of start of RRT, cumulative percentage time on a functioning graft, and greater height SDS at initiation of RRT were independently associated with a higher final height SDS. Patients with congenital anomalies of the kidney and urinary tract and metabolic disorders had a lower final height than those with other primary renal diseases.Conclusions Although final height remains suboptimal in children with ESRD, it has consistently improved over time.

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“…(24,25) This is relevant, because children with chronic renal failure often have short stature and impairment of linear growth even after successful RTx. (34)(35)(36) However, because delayed puberty and delayed skeletal maturation are common in these children, we found it important to correct the BMD values for bone age, especially in the adolescents, to avoid overestimation of the BMD reduction. In this cohort, bone age was delayed by >1 yr in almost one half of the patients.…”

mentioning

confidence: 99%

Bone Health in Children and Adolescents After Renal Transplantation

Valta

Mäkitie

Rönnholm

et al. 2009

Journal of Bone and Mineral Research

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ABSTRACT:The basis for lifelong bone health is established in childhood and adolescence. Whereas pediatric renal transplant (RTx) patients are at risk for impaired bone mass gain and fractures, scarce data on this subject are available. We performed a cross-sectional and longitudinal study of bone health in a national cohort of 106 pediatric RTx patients (median age, 12.6 yr; median follow-up, 5.1 yr after RTx). The patients underwent clinical evaluation, DXA for BMD, and spinal imaging for vertebral fractures. In longitudinal analysis, the median lumbar spine BMD Z-score was lowest (median, 21.0) at 1 yr postoperatively but increased to a peak value of 20.2 at 5 yr. In boys, the lumbar spine BMD Z-score increased also during puberty but decreased in girls. In cross-sectional analysis, the lumbar spine, hip, and whole body BMD Zscores were < 22 SD in 4%, 6%, and 6% of the patients, respectively. Sixteen percent had sustained peripheral fractures, and 8% had vertebral fractures. Female sex and age >15 yr (OR, 56.26; 95% CI, 5.17-611.82; p = 0.0007) as well as high plasma PTH levels (OR, 4.03; 95% CI, 1.37-11.85; p = 0.009) were significant predictors for low BMD. Three-year cumulative glucocorticoid dose, outside the immediate postRTx years, was not associated with BMD parameters. The observed BMD results were satisfactory. However, the high (8%) prevalence of vertebral fractures warrants careful evaluation of bone health in these patients.

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Kidney transplanted children come of age

Cited by 145 publications

References 34 publications

Factors Related to Graft Outcome in Pediatric Renal Transplantation: a Single Center Study

Factors Related to Graft Outcome in Pediatric Renal Transplantation: a Single Center Study

Adult Height in Patients with Advanced CKD Requiring Renal Replacement Therapy during Childhood

Bone Health in Children and Adolescents After Renal Transplantation

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