Short stature in advanced pediatric CKD is associated with faster time to reduced kidney function after transplant.

Document Type

Article

Publication Date

5-2019

Identifier

DOI: 10.1007/s00467-018-4165-2; PMCID: PMC6424594

Abstract

BACKGROUND: Among children who receive a kidney transplant, short stature is associated with a more complicated post-transplant course and increased mortality. Short stature prior to transplant may reflect the accumulated risk of multiple factors during chronic kidney disease (CKD); however, its relationship with post-transplant kidney function has not been well characterized.

METHODS: In the Chronic Kidney Disease in Children (CKiD) cohort restricted to children who received a kidney transplant, short stature (i.e., growth failure) was defined as age-sex-specific height < 3rd percentile. The outcome was time to estimated glomerular filtration rate (eGFR) < 45 ml/min/1.73 m

RESULTS: Of 138 children (median CKD duration at transplant: 13 years), 20% (28) had short stature before the transplant. The median time to eGFR < 45 ml/min/1.73 m

CONCLUSIONS: Short stature was associated with a faster time to low kidney function after transplant. SES, disease severity, and parental height partially explained the association. Clinicians should be aware of the implications of growth failure on the outcome of this unique population, while continued attempts are made to define modifiable factors that contribute to this association.

Journal Title

Pediatric nephrology (Berlin, Germany)

Volume

34

Issue

5

First Page

897

Last Page

905

MeSH Keywords

Adolescent; Body Height; Child; Female; Glomerular Filtration Rate; Growth Disorders; Humans; Kidney Transplantation; Male; Prospective Studies; Renal Insufficiency, Chronic; Severity of Illness Index; Time Factors; Treatment Outcome

Keywords

GFR; Graft loss; Growth failure; Kidney transplantation

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