Département de Pédiatrie and Inserm U820, Hôpital Edouard-Herriot and Université Claude-Bernard Lyon 1, Lyon, France.

Growth may be severely impaired in children with chronic renal insufficiency. Since short stature can have major consequences on quality of life and self-esteem, achieving a 'normal' height is a crucial issue for renal transplant recipients. However, despite successful renal transplantation, the final height attained by most recipients is not the calculated target height. Catch-up growth spurts post-transplantation are usually insufficient to compensate for the retardation in growth that has occurred during the pre-transplant period. Longitudinal growth post-transplantation is therefore influenced by the age at transplantation but also by subsequent allograft function and steroid exposure, both of which interfere with the growth hormone/insulin-like growth factor axis. The management of growth retardation in renal transplant recipients includes adequate nutritional intake, correction of metabolic acidosis, prevention of bone disease, steroid-sparing strategies and a supraphysiological dose of recombinant human growth hormone in selected cases.

Written by
Harambat J, Cochat P.

Reference
Pediatr Nephrol. 2008 Mar 26. Epub ahead of print.
doi:10.1007/s00467-008-0787-0

PubMed Abstract
PMID:18365255

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