Factors Associated With Height Among Pediatric Kidney Transplant Recipients Aged ≤16 Years: A Retrospective, Single-Center Cohort Study of 60 Transplants

Objectives: The aim of this study was to describe the factors associated with growth before and after kidney transplant. Materials and Methods: We retrospectively reviewed 60 pediatric patients with end-stage kidney disease aged ≤16 years who underwent kidney transplant at our facility between November 2001 and March 2018. Height standard deviation score and possible associated factors were also compared. Results: Among the 60 patients, median age was 11 years (interquartile range, 5.3-14 years), and 24 (40%) were female. All patients were alive during the observational period. The 2-, 5-, and 15-year graft survival rates were 96.7%, 94.4%, and 77.8%, respectively. Mean height standard deviation score for preoperative kidney transplant was-2.1 ± 1.5. Duration of dialysis (months) was associated with preoperative height standard deviation score (β =-0.020; standard error = 0.006; t =-3.23; P =.002). Higher age and episode of rejection were significant factors for loss of catch-up growth (P <.001 and P =.023, respectively). In total, 26 patients (43.3%) and 19 patients (31.7%) had short stature preoperatively and at 2 years after kidney transplant, respectively. Although 23 patients (38.3%) presented with catch-up growth after kidney transplant, 14 (53.9%) remained with short stature even 2 years after kidney transplant. Height standard deviation score 2 years after kidney transplant was associated with age, preoperative height standard deviation score, and episodes of rejection (P =.032, P <.001, and P =.005, respectively). Conclusions: Our study suggests that, although kidney transplant results in catch-up growth in pediatric patients, short stature often persists even 2 years after kidney transplant and is affected by age, preoperative height standard deviation score, and episodes of rejection.