ESPN 53rd Annual Meeting

ESPN 2021


 
GROWTH AFTER PEDIATRIC KIDNEY TRANSPLANTATION: THE EFFECT OF PRETRANSPLANT RECOMBINANT GROWTH HORMONE AND POSTTRANSPLANT STEROID THERAPY
GILLES TOURLAMAIN 1 MANDY G. KEIJZER-VEEN 2 ANTONIA H.M. BOUTS 3 KARLIEN CRANSBERG 4 HUIB DE JONG 4 RANI DE PAUW 1 KAREN VANDERSTRAETEN 4 AMINA EL AMOURI 1 ANN RAES 1 NOEL KNOPS 5 AGNIESZKA PRYTULA 1

1- GHENT UNIVERSITY HOSPITAL, GHENT, BELGIUM
2- WILHELMINA CHILDRENS HOSPITAL, UNIVERSITY MEDICAL CENTRE, UTRECHT, THE NETHERLANDS
3- EMMA CHILDRENS HOSPITAL, AMSTERDAM UNIVERSITY MEDICAL CENTRE, AMSTERDAM, THE NETHERLANDS
4- SOPHIA CHILDRENS HOSPITAL, ERASMUS MEDICAL CENTRE, ROTTERDAM, THE NETHERLANDS
5- LEUVEN UNIVERSITY HOSPITALS, LEUVEN, BELGIUM
 
Introduction:

We aimed to analyze the effect of pretransplant recombinant human growth hormone (rhGH) and corticosteroid withdrawal on longitudinal growth in the 1st year after kidney transplantation (kTx) and to identify factors associated with final height (FH) in pediatric kTx recipients.

Material and methods:

Patients who underwent kTx between 1996 and 2018 in 5 Belgian and Dutch centers before the age of 18 yrs were included in this retrospective study. We analyzed the differences between height SDS at kTx and 1 year post kTx (D height SDS) in children who were and were not treated with rhGH before kTx (rhGH+ and rhGH-) and those with and without corticosteroids at 1 year (CS+ and CS-). Univariate and multivariate linear regression analysis was performed to identify factors associated with height SDS at 1 year post kTx, D height SDS and FH SDS.

Results:

179 patients were included, with a median age at kTx 9.27 years. The median height SDS before kTx and 1 year after kTx in the CS-/rhGH-, CS+/rhGH-, CS-/rhGH+ and CS+/rhGH+ groups were respectively -1.42/-0.80, -0.90/-0.62, -1.35/-1.20 and -1.30/-1.60 (p=0.001). Corticosteroid use at 1 year post kTx was the only factor associated with D height SDS on multivariate analysis (p=0.003). Median FH SDS, available in 124 patients, was -0.80 (range:-7.30 – 3.10). There was an association between FH and D height SDS at 1 year (p<0.001). Of 96 patients with height SDS <-1 at 1 year, 64 had FH <-1 SDS. Corticosteroid dose at 1 year was associated with FH on multivariate analysis (p=0.014).

Conclusions:

Growth in the first year post kTx was highest in the CS-/rhGH- group and lowest in the CS+/rhGH+ group. The use of corticosteroids at 1 year post kTx is the most important factor associated with growth in children in the 1st year after kTx and their final height.