Kidney Week

Abstract: TH-PO813

Linear Growth after Pediatric Kidney Transplant: Factors Influencing Catch-Up Growth in a Retrospective Cohort

Session Information

• Transplantation: Clinical - 2
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Ribeiro, Patrick, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Patrick Ribeiro

• Campelo, Paula Setti, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Paula Setti Campelo

• Borges, João Victor Ribas de Abreu, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

João Victor Ribas de Abreu Borges

• Stakonski, Leonardo Pelisser, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Leonardo Pelisser Stakonski

• Hesler, Marcos Krüger, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Marcos Krüger Hesler

• De Barros, Marco Antonio Morche, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Marco Antonio Morche De Barros

• Sylvestre, Lucimary De Castro, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Lucimary De Castro Sylvestre, MD

• Peralta, Maria Helena, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Maria Helena Peralta, PhD

• Moreno-Amaral, Andrea Novais, Pontificia Universidade Catolica do Parana, Curitiba, PR, Brazil

Andrea Novais Moreno-Amaral, PhD

Background

Children with chronic kidney disease often face growth deficits due to electrolyte, nutritional, and hormonal issues. Kidney transplantation (KT) can enhance growth, but catch-up growth (CUG) to expected height for age is not always achieved. Understanding post-transplant (PT) growth is vital for optimizing interventions, such as growth hormone (GH) use, which is limited in Brazil. Therefore, this study aims to identify the prevalence and factors associated with sufficient CUG in children who underwent KT.

Methods

This retrospective cohort study at a tertiary pediatric nephrology center in Brazil included patients under 18 who had KTs between 2010 and 2023. Data were collected from medical records. Sufficient CUG was defined as an increase in height standard deviation score (SDS) ≥ 0.5 SD from pre-transplant to 2 years PT. Weight, height SDS and BMI-for-height-age SDS were compared using ANOVA for repeated measures, followed by Bonferroni post hoc tests for normally distributed variables, and the Friedman test with Bonferroni-adjusted significance level post hoc analysis for non-normal variables. Logistic regression was used to identify pre-transplant factors associated with CUG, with significance set at 5%.

Results

The sample included 27 patients (mean age 9.4 years, 81.5% male). Dialysis modalities included peritoneal (44.4%), hemodialysis (29.6%), and both (18.5%). Uropathy was the main etiology (51.9%). None used GH during follow-up. Preemptive transplants accounted for 7.4%. KT significantly improved weight (p<0.001), height SDS (p<0.024), and BMI-for-height-age (p<0.002), with more pronounced gains in the first 6 months. Improvements stabilized between 6 months and 1 year. Among the 22 patients who followed up to 2 years, sufficient CUG was observed in 18.2%. Univariate and multivariate analyses found no significant associations between the pre-transplant characteristics and CUG.

Conclusion

KT significantly improved height and weight, though only a small proportion achieved sufficient CUG after 2 years. Larger studies are needed to identify factors involved in CUG and optimize interventions.