Dogan Cagla Serpil, Durmaz Erdem, Comak Elif, Uslu Gokceoglu Arife, Koyun Mustafa, Akman Sema
Department of Pediatric Nephrology, Akdeniz University, Antalya, Turkey.
Exp Clin Transplant. 2013 Aug;11(4):315-9. doi: 10.6002/ect.2012.0226. Epub 2013 Mar 7.
Linear growth impairment frequently accompanies chronic kidney disease in children. Despite successful renal transplant, growth retardation may persist in renal allograft recipients.
We recorded the longitudinal growth and biochemical data of prepubertal children during the first 2 years after renal transplant in 34 children (18 boys [52.9%]; mean age at renal transplant, 7.3 ± 2.5 y; range, 1.4 to 9.8 y). Height standard deviation scores were calculated. The patients were divided into 2 groups according to the increase in height standard deviation scores over the first 2 years after renal transplant: group 1 (increases in height standard deviation scores < 1) and group 2 (increases in height standard deviation scores > 1).
Increases in height standard deviation scores were 0.12 ± 0.34 and 1.62 ± 0.52 for group 1 and group 2 (P < .001). The number of acute rejection episodes was significantly different between groups (P = .04). At renal transplant, increases in height standard deviation scores were negatively correlated with mean age (r: -0.354; P = .04) and height standard deviation scores (r: -0.353; P = .04). In the multivariate model, mean age and height standard deviation scores at renal transplant remained significantly associated with increases in height standard deviation scores (P = .018; β coefficient: -0.341, 95% CI: -0.17; -0.002; and P = .005; β coefficient: -0.431, 95% CI: -0.519; -0.101).
Renal transplant improves linear growth by providing moderate or accelerated growth in prepubertal children.
线性生长障碍常伴随儿童慢性肾脏病。尽管肾移植成功，但肾移植受者可能仍存在生长迟缓。
我们记录了34例青春期前儿童肾移植后前2年的纵向生长和生化数据（18例男孩[52.9%]；肾移植时平均年龄7.3±2.5岁；范围1.4至9.8岁）。计算身高标准差分数。根据肾移植后前2年身高标准差分数的增加情况将患者分为2组：第1组（身高标准差分数增加<1）和第2组（身高标准差分数增加>1）。
第1组和第2组的身高标准差分数增加分别为0.12±0.34和1.62±0.52（P<.001）。两组间急性排斥反应发作次数有显著差异（P=.04）。肾移植时，身高标准差分数的增加与平均年龄呈负相关（r：-0.354；P=.04）以及与身高标准差分数呈负相关（r：-0.353；P=.04）。在多变量模型中，肾移植时的平均年龄和身高标准差分数仍与身高标准差分数的增加显著相关（P=.018；β系数：-0.341，95%CI：-0.17；-0.002；以及P=.005；β系数：-0.431，95%CI：-0.519；-0.101）。
肾移植通过使青春期前儿童适度生长或加速生长来改善线性生长。
