Search

Objective: Kidney transplantation can improve linear growth in pediatric recipients but may not ensure attainment of the target adult height. The aim of this study is to determine the prevalence of growth failure in pediatric kidney transplantation recipients and to investigate the factors that influence growth. Methods: This single-center retrospective study included 62 kidney transplantation recipients (37 males) transplanted before 18 years of age. Patients’ medical records were retrospectively reviewed for annual posttransplant anthropometric measurements. Target height was calculated based on midparental height. The standard deviation score of height was calculated for baseline (at transplantation), final (at study time), and target heights. Results: The median age at transplantation was 11.9 (8.8-14.8) years, and the median follow-up time after transplantation was 5.9 (3.2-7.2) years. Forty-seven children (76%) had growth failure (standard deviation score of height < –1.88) at baseline. After transplantation, a significant increase in the standard deviation score of height was observed between baseline and final (P < .001); however, the final standard deviation score of height was significantly lower than the target standard deviation score of height (P < .001), and 38 patients (61%) still had growth failure at final examination. Twenty-seven patients (43.5%) achieved their target SD score of height. Children transplanted over 12 years had lower growth velocity (cm/year) than those transplanted at 2-5 years and 5-12 years (P < .05). A high final standard deviation score of height was independently associated with lower transplant age, higher baseline standard deviation score of height, and lower cumulative steroid dose (P < .05 for all). Conclusion: Kidney transplantation improves linear growth in pediatric recipients, but growth failure is still common after transplantation, and most patients are unfortunately far from their target height. [ABSTRACT FROM AUTHOR]

Objective: There is an increased risk of obesity and metabolic syndrome among kidney transplant recipients, which adversely affects cardiovascular and renal outcomes in these patients. The present study aims to investigate the prevalence of metabolic syndrome in pediatric kidney transplant recipients and the associations of metabolic syndrome with cardiovascular disease and graft function. Materials and Methods: This cross-sectional, single-center study included 52 kidney transplant recipients (27 males) transplanted before 18 years of age. All subjects underwent a comprehensive assessment that included anthropometric and blood pressure measurements and laboratory tests. Metabolic syndrome was defined based on the recent recommendations of the Pediatric Renal Nutrition Taskforce. Left ventricular hypertrophy was assessed as a risk factor for cardiovascular disease, and estimated glomerular filtration rate was assessed to determine graft function. Results: The median age of patients was 15.9 (13.8;18.4) years, and the median follow-up time was 35.5 (20.0;62;0) months after transplantation. Nineteen patients (36.5%) were obese or overweight, 43 (83%) had hypertension or controlled hypertension, 23 (44%) had dyslipidemia, and 9 (17%) had hyperglycemia. Ten patients (19.2%) were diagnosed with metabolic syndrome. Twenty-eight patients (54%) had left ventricular hypertrophy. The prevalence of left ventricular hypertrophy was higher in patients with metabolic syndrome than in those without metabolic syndrome (90% vs. 45%, P = .014), whereas estimated glomerular filtration rate did not differ between the 2 groups. Conclusion: Cardiometabolic risk factors are common in pediatric kidney transplant recipients. Approximately one-fifth of patients have metabolic syndrome, and left ventricular hypertrophy is much more common among patients with metabolic syndrome. However, there is no relationship between metabolic syndrome and graft dysfunction. [ABSTRACT FROM AUTHOR]