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Growth in Children After a Kidney Transplant: A Retrospective, Observational Single-Center Study

Background: 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. Objectives: 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. Patients and methods: 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. Results: 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. Conclusion: 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.