Abstract: TH-PO960

Pubertal and Growth Development of Children and Adolescents Following Renal Transplantation

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Büscher, Rainer, University of Duisburg-Essen, Pediatrics 2, Essen, Germany
  • Serdar, Deniz, University of Duisburg-Essen, Pediatrics 2, Essen, Germany
  • Kiewert, Cordula, University of Duisburg-Essen, Pediatrics 2, Essen, Germany
  • Hoyer, Peter F., University of Duisburg-Essen, Pediatrics 2, Essen, Germany
  • Büscher, Anja K., University of Duisburg-Essen, Pediatrics 2, Essen, Germany
Background

Children with chonic kidney disease often show a delayed pubertal development and growth restriction, which is an enormous psycho-social stress factor. The improvement of renal function following RTx seems to positively influence some of the involved mechanisms. We analyzed pubertal development and growth in children following RTx in order to identify potential risk factors.

Methods

Data of 90 children (0-18 years, 32 ♀) from our center who underwent RTx between 2000-2015 have been retrospectively analyzed. Mean observation time was 6.7 years. We studied the influence of gender, age, underlying disease, mode and duration of dialysis, glucocorticoid and growth hormone therapy prior to RTx, renal function and immunosuppression on the annual course of weight and growth, bone age, testicle volume, estradiol/testosterone levels, age at onset of menarche and change of pubertal Tanner-stage.

Results

Mean age at RTx was 6.8 years (±4.7 years). Length (-1.6SD) and weight (-0.9SD) were reduced prior to RTx and we found a pronounced dissociation between skeletal and chronological age. While all patients gained weight (p=0.007) following RTx, length and dissociation of bone age showed no improvement (p=0.032). On the contrary, the dissociation was more pronounced in the group of patients between 7-12 years (p<0.05). Patients receiving growth hormone therapy prior to RTx showed a negative dissociation and reduced length at time of RTx and presentd an accelerated catch-up-growth with no further significant differences after RTx. Living kidney donation was associated with a significantly enhanced length (-0.9SD vs. -1.7SD, p=0.025). Age at onset of menarche (12.98±1.64 years, normal range 11.2-15.6 years) and change from Tanner-stage P1 to P2 (11.2±15.6, normal range 8-12.6 years) were in the upper normal range. Boys were 12.3±1.5 years old (normal range 9.2-15.2 years) at transition to P2. No dependancy on gender, disease, duration and mode of dialysis, immunosuppression or prior glucocorticoid therapy could be observed.

Conclusion

The majority of our patients showed a timely pubertal development following RTx. Despite a improved renal function, growth and bone age remained retarded.