ESPN 53rd Annual Meeting

ESPN 2021


 
Final height of children over 12 years initiated on a steroid minimisation immunosuppressive regimen following kidney transplantation
DEMETRIA THEODOROU 1 THOMAS DOWSETT 2 RICHARD HOLT 2 MOHAN SHENOY 1

1- ROYAL MANCHESTER CHILDREN’S HOSPITAL
2- ALDER HEY CHILDREN’S HOSPITAL
 
Abstract:

Objectives: A large European study reported that only 55% of adults who started renal replacement therapy in childhood achieved normal height. Previous studies have not demonstrated catch-up growth in children ≥12 years at the time of transplantation. Our aim was to characterise final height outcome in children who underwent kidney transplantation at age ≥12 years using a CSM immunosuppressive regimen.

Method: A retrospective review of electronic records was performed on patients who underwent a kidney transplant at ³12 years and were initiated on a CSM immunosuppressive protocol from 2009 to 2019. Final height (FH) was defined as height at ≥18 years (or <1cm growth in the last 12 months). Normal FH was defined as SDS ≥-1.88.

Results: 51 patients were included (mean follow-up 2.6 years, range 0.26-5.49). Median age at last follow-up was 18.4 years (17.4-19). A normal FH SDS was achieved in 36 (71%). Median height at transplantation was SDS -1.19 and the median final height SDS was -0.86 (median FH was 152.5cm in girls and 173.2cm in boys). The significant factors associated with achieving normal FH were male gender (p= 0.03), and shorter duration of dialysis (p=0.019). All boys (n=9) transplanted under the age of 15 years achieved normal FH (SDS -1.46 to 1.66). 73% (37) of patients had a normal BMI SDS, 12% (6) were overweight and 12% (6) were obese. 41% (21) were on antihypertensive medication at the last paediatric follow-up.

Conclusion: 71% of children ³12 initiated on a CSM immunosuppressive protocol achieved normal FH. Boys <15 years were more likely to achieve a normal FH compared to girls of a similar age.