Skip to main content
SpringerLink
Log in

Final adult height in kidney recipients who underwent highly successful transplantation as children: a single-center experience

  • Original Article
  • Published:
Clinical and Experimental Nephrology Aims and scope Submit manuscript

Abstract

Background

Achieving a normal final adult height (FH) remains a challenge in the field of pediatric kidney transplantation (KTx). To examine the optimal approach to assuring normal FH following KTx, we retrospectively examined the post-transplant growth and FH of pediatric KTx recipients.

Methods

Since the relevant factors affecting the FH of children following KTx are multifactorial and notably complex, KTx recipients with persistent good graft function and successful steroid minimization until FH attainment were selected for this study.

Results

Thirteen patients were enrolled in this study. The mean estimated glomerular filtration rate was 72.1 ± 15.3 ml/min/1.73 m2, and the mean corticosteroid dose was 0.05 ± 0.05 mg/kg on alternate days at the time of FH attainment. Despite highly successful KTx, four (30.8 %) patients (one who underwent KTx before puberty and three during puberty) showed a decrease in the height standard deviation score (hSDS) from the time of KTx until FH attainment. Moreover, of these, two male patients had an FH with an SD <−2.

Conclusion

FH remained suboptimal despite highly successful KTx. Not only highly successful KTx but also further treatment such as steroid avoidance, early steroid withdrawal or using rhGH might be necessary to assure a normal FH in some pubertal patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Harambat J, Cochat P. Growth after renal transplantation. Pediatr Nephrol. 2009;24:1297–306.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Broyer M, Le Bihan C, Charbit M, Guest G, Tête MJ, Gagnadoux MF, Niaudet P. Long-term social outcome of children after kidney transplantation. Transplantation. 2004;77:1033–7.

    Article  PubMed  Google Scholar 

  3. Fine RN. Management of growth retardation in pediatric recipients of renal allografts. Nat Clin Pract Nephrol. 2007;3:318–24.

    Article  PubMed  Google Scholar 

  4. Cochat P, Harambat J. Maximizing growth in children after renal transplantation. Transplantation. 2009;88:1321–2.

    Article  PubMed  Google Scholar 

  5. Hokken-Koelega AC, van Zaal MA, van Bergen W, de Ridder MA, Stijnen T, Wolff ED, de Jong RC, Donckerwolcke RA, de Muinck Keizer-Schrama SM, Drop SL. Final height and its predictive factors after renal transplantation in childhood. Pediatr Res. 1994;36:323–8.

    Article  CAS  PubMed  Google Scholar 

  6. Broyer M, Guest G, Gagnadoux MF. Growth rate in children receiving alternate day corticosteroid treatment after kidney transplantation. J Pediatr. 1992;120:721–5.

    Article  CAS  PubMed  Google Scholar 

  7. Fine RN, Martz K, Stablein D. What have 20 years of data from the North American Pediatric Renal Transplant Cooperative Study taught us about growth following renal transplantation in infants, children, and adolescents with end-stage renal disease? Pediatr Nephrol. 2010;25:739–46.

    Article  PubMed  Google Scholar 

  8. Nissel R, Brázda I, Feneberg R, Wigger M, Greiner C, Querfeld U, Haffner D. Effect of renal transplantation in childhood on longitudinal growth and adult height. Kidney Int. 2004;66:792–800.

    Article  PubMed  Google Scholar 

  9. Hattori M, Akioka Y, Chikamoto H, Kobayashi N, Tsuchiya K, Shimizu M, Kagami S, Tsukaguchi H. Increase of integrin-linked kinase activity in cultured podocytes upon stimulation with plasma from patients with recurrent FSGS. Am J Transplant. 2008;8:1550–6.

    Article  CAS  PubMed  Google Scholar 

  10. Suwa S, Tachibana K, Maesaka H, Tanaka T, Yokoya S. Longitudinal standards for height and height velocity for Japanese children from birth to maturity. Clin Pediatr Endocrinol. 1992;1:5–13.

    Article  Google Scholar 

  11. Murata M. Japanese specific bone age standard on the TW 2. Clin Pediatr Endocrinol. 1993;2(Suppl 3):35–41.

    Article  Google Scholar 

  12. Schwartz GJ, Brion LP, Spitzer A. The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents. Pediatr Clin North Am. 1987;34:571–90.

    CAS  PubMed  Google Scholar 

  13. Fine RN. Etiology and treatment of growth retardation in children with chronic kidney disease and end-stage renal disease: a historical perspective. Pediatr Nephrol. 2010;25:725–32.

    Article  PubMed  Google Scholar 

  14. Englund MS, Tydén G, Wikstad I, Berg UB. Growth impairment at renal transplantation: a determinant of growth and final height. Pediatr Transplant. 2003;7:192–9.

    Article  PubMed  Google Scholar 

  15. Schaefer F, Seidel C, Binding A, Gasser T, Largo RH, Prader A, Schärer K. Pubertal growth in chronic renal failure. Pediatr Res. 1990;28:5–10.

    Article  CAS  PubMed  Google Scholar 

  16. Maxwell H, Haffner D, Rees L. Catch-up growth occurs after renal transplantation in children of pubertal age. J Pediatr. 1998;133:435–44.

    Article  CAS  PubMed  Google Scholar 

  17. Klare B, Montoya CR, Fisher DC, Stangl MJ, Haffner D. Normal adult height after steroid-withdrawal within 6 months of pediatric kidney transplantation: a 20 years single center experience. Transplant Int. 2012;25:276–82.

    Article  CAS  Google Scholar 

  18. Delucchi Á, Valenzuela M, Lillo AM, Guerrero JL, Cano F, Azocar M, Zambrano P, Salas P, Pinto V, Ferrario M, Rodriguez J, Cavada G. Early steroid withdrawal in pediatric renal transplant: five years of follow-up. Pediatr Nephrol. 2011;26:2235–44.

    Article  PubMed  Google Scholar 

  19. Grenda R, Watoson A, Trompeter R, Tönshoff B, Jaray J, Fitzpatrick M, Murer L, Vondrak K, Maxwell H, van Damme -Lombaerts R, Loirat C, Mor E, Cochat P, Milford DV, Brown M, Webb NJ. A randomized trial to assess the impact of early steroid withdrawal on growth in pediatric renal transplantation: The TWIST study. Am J Transplant. 2010;10:828–36.

  20. Li L, Chang A, Naesens M, Kambham N, Waskerwitz J, Martin J, Wong C, Alexander S, Grimm P, Concepcion W, Salvatierra O, Sarwal MM. Steroid-free immunosuppression since 1999: 129 pediatric renal transplants with sustained graft and patients benefits. Am J Transplant. 2009;9:1362–72.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Grenda R. Effects of steroid avoidance and novel protocols on growth in paediatric renal transplant patients. Pediatr Nephrol. 2010;25:747–52.

    Article  PubMed  Google Scholar 

  22. Höcker B, Weber LT, Feneberg R, Drube J, John U, Fehrenbach H, Pohl M, Zimmering M, Fründ S, Klaus G, Wühl E, Tönshoff B. Prospective, randomized trial on late steroid withdrawal in pediatric renal transplant recipients under cyclosporine micro emulsion and mycophenolate mofetil. Transplantation. 2009;87:934–41.

    Article  PubMed  Google Scholar 

  23. Motoyama O, Hasegawa A, Aikawa A, Shishido S, Honda M, Tsuzuki K, Kinukawa T, Hattori M, Ogawa O, Yanagihara T, Saito K, Takahashi K, Oshima S. Final height in a prospective trial of late steroid withdrawal after pediatric renal transplantation treated with cyclosporine and mizoribine. Pediatr Transplant. 2012;16:78–82.

    Article  CAS  PubMed  Google Scholar 

  24. Tainio J, Qvist E, Vehmas R, Jahnukainen K, Hölttä T, Valta H, Jahnukainen T, Jalanko H. Pubertal development is normal in adolescents after renal transplantation in childhood. Transplantation. 2011;92:404–9.

    Article  PubMed  Google Scholar 

  25. Hokken-Koelega AC, Stijnen T, de Ridder MA, de Muinck Keizer-Schrama SM, Wolff ED, de Jong MC, Donckerwolcke RA, Groothoff JW, Blum WF, Drop SL. Growth hormone treatment in growth-retarded adolescents after renal transplantation. Lancet. 1994;343:1313–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The authors gratefully acknowledge Drs. Masataka Hisano, Kiyonobu Ishizuka and Noriko Sugawara, Department of Pediatric Nephrology, Tokyo Women’s Medical University, for providing care for these patients.

Conflict of interest

The authors have declared that no conflict of interest exists.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Koseiren Hiroshima General Hospital, 1-3-3 Zigozen, Hatsukaichi-shi, Hiroshima, 738-8503, Japan

    Hiroshi Fujii

  2. Department of Pediatric Nephrology, Tokyo Women’s Medical University, School of Medicine, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Hiroko Chikamoto, Yuko Akioka & Motoshi Hattori

Authors
  1. Hiroshi Fujii
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroko Chikamoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuko Akioka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Motoshi Hattori
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Motoshi Hattori.

About this article

Cite this article

Fujii, H., Chikamoto, H., Akioka, Y. et al. Final adult height in kidney recipients who underwent highly successful transplantation as children: a single-center experience. Clin Exp Nephrol 18, 515–520 (2014). https://doi.org/10.1007/s10157-013-0842-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10157-013-0842-4

Keywords

Search

Navigation