Elamin Mugahid, Alabbasi Bashair, Aloufi Majed
Pediatric Nephrology, Prince Sultan Military Medical City, Riyadh, SAU.
Cureus. 2024 Sep 9;16(9):e69003. doi: 10.7759/cureus.69003. eCollection 2024 Sep.
Kidney transplantation (KTX) is the best treatment for children with end-stage kidney disease (ESKD). It greatly improves their quality of life. Children's growth is one of the chronic issues that is known to be compromised during ESKD; therefore, catch-up growth is usually expected to be seen after KTX.
We aimed to evaluate children's catchup growth after KTX and assess the impact of children's age at the time of KTX on catchup growth.
We performed a retrospective analysis of weight and height data for children pre-KTX, at 12 months, and 24 months post KTX. We stratified them into five percentile categories for weight and height and counted the number of KTX patients in each category at the same three time points. We also stratified them into three different age groups: two to five, six to 10, and 11 to 12 years, and estimated the mean and standard deviation of both weight and height of each one.
Between 2009 and 2019, we identified 37 children who underwent KTX. The mean weight pre-KTX was 21 kg. It increased to 28 and 34 kg post KTX at 12 and 24 months, respectively. The mean height pre-KTX was 115 cm. It increased to 126 and 134 cm post KTX at 12 and 24 months, respectively. There was a significant crossing of both weight and height percentiles when we stratified them based on different initial percentiles. There was a significant change in both weight and height when we stratified them into three age groups: two to five, six to 10, and 11 to 14 years.
The growth patterns of children after a KTX can vary among children. However, our retrospective observational study showed positive results, suggesting gradual improvement in weight and height gain post KTX. Factors such as age at the time of KTX, duration of kidney disease, medication regimens, and overall health status can influence a child's growth trajectory. Close monitoring, proper nutrition, and a multidisciplinary approach are essential in supporting a child's growth after a KTX. Our findings are limited by the small sample size and retrospective design, therefore a well-structured prospective study with a large sample size is required.
肾移植（KTX）是终末期肾病（ESKD）患儿的最佳治疗方法。它能极大地改善他们的生活质量。儿童生长是已知在ESKD期间会受到影响的慢性问题之一；因此，通常预期在肾移植后会出现追赶生长。
我们旨在评估肾移植后儿童的追赶生长情况，并评估肾移植时儿童年龄对追赶生长的影响。
我们对肾移植前、肾移植后12个月和24个月时儿童的体重和身高数据进行了回顾性分析。我们将他们按体重和身高分为五个百分位数类别，并统计了在相同三个时间点每个类别中的肾移植患者数量。我们还将他们分为三个不同年龄组：2至5岁、6至10岁和11至12岁，并估计了每个年龄组体重和身高的均值及标准差。
在2009年至2019年期间，我们确定了37名接受肾移植的儿童。肾移植前平均体重为21千克。肾移植后12个月和24个月时分别增至28千克和34千克。肾移植前平均身高为115厘米。肾移植后12个月和24个月时分别增至126厘米和134厘米。当我们根据不同的初始百分位数对他们进行分层时，体重和身高百分位数均有显著交叉。当我们将他们分为三个年龄组：2至5岁、6至10岁和11至14岁时，体重和身高均有显著变化。
肾移植后儿童的生长模式在不同儿童之间可能存在差异。然而，我们的回顾性观察研究显示出积极结果，表明肾移植后体重和身高增长逐渐改善。肾移植时的年龄、肾病持续时间、药物治疗方案和整体健康状况等因素会影响儿童的生长轨迹。密切监测、适当营养和多学科方法对于支持肾移植后儿童的生长至关重要。我们的研究结果受样本量小和回顾性设计的限制，因此需要进行一项结构良好的大样本前瞻性研究。
