Endocrine Abstracts

Objective: Impaired linear growth is a common complication of end stage renal failure (ESRF), with recombinant human growth hormone (rhGH) being the suggested treatment until renal transplantation (RTx). Growth improvement post RTx has been reported, however data on the degree of catch up growth post RTx and final height (FH) is limited. We aimed to evaluate the effect of RTx on FH standard deviation score (SDS) and the possible contributing factors.

Methods: We performed a retrospective review of medical records of RTx recipients from a single UK centre. We recorded demographic data, height SDS before RTx and FH SDS, treatment with rhGH and eGFR until FH. We analyzed change in height SDS prior to RTx and at FH and possible predictive factors.

Results: 33 RTx patients (17 males/16 females) with normal graft function were included. Mean age of RTx was 9.5 years. RhGH was administered before RTx in 12 patients. Height SDS increased significantly from pre RTx (mean Ht SDS -2.0, median -2.0, range -4.33 to 1.88) to FH (mean Ht SDS -0.9, median -1.13, range -3.72 to 1.37), P < 0.001. 29 patients (88%) had a normal height > -2.0 SD. The mean change on height SDS from before RTx to FH was +1.1. There was a significant correlation between age of RTx and increase of height SDS from before RTx to FH, R: -0.373, P = 0.032. Multiple regression analysis (including age of RTx, rhGH treatment before RTx and gender) showed that age of RTx was an independent predictive factor of the height SDS increase.

Conclusion: In our group, we observed a sustained increase in height post RTx resulting in normal FH. RTx especially in younger recipients seems to result in adequate catch up growth that can compensate for the deficit occurring due to ESRF.