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Journal of the Korean Society of Pediatric Nephrology 2006;10(2): 219-227.
소아 신장이식 후 성장에 대한 평가
이지웅, 김정수, 김양욱, 김영훈, 윤영철, 정우영
1인제대학교 의과대학 소아과학교실
2인제대학교 의과대학 소아과학교실
3인제대학교 의과대학 내과학교실
4인제대학교 의과대학 내과학교실
5인제대학교 의과대학 흉부외과학교실
6인제대학교 의과대학 흉부외과학교실
Evaluation of Effect of Renal Transplantation on Growth in Children with Chronic Renal Failure
Ji-Woong Lee, Jung-Soo Kim, Yang-Wook Kim, Young-Hoon Kim, Young-Chul Yoon, Woo-Yeong Chung
1Department of Pediatrics, College of Medicine, Inje University
2Department of Pediatrics, College of Medicine, Inje University
3Department of Internal Medicine, College of Medicine, Inje University
4Department of Internal Medicine, College of Medicine, Inje University
5Department of Cardiac Surgery, College of Medicine, Inje University
6Department of Cardiac Surgery, College of Medicine, Inje University
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ABSTRACT
Purpose : We aim to identify the clinical and demographic characteristics in children who underwent renal transplantation(RTx) and to evaluate the influence on growth of RTx in children.
Methods : We reviewed 17 medical records of chronic renal failure patients who underwent RTx from April 1992 and June 2004 at Busan Paik Hospital. Age and sex distribution, cause of disease, donor analysis, patient and graft survival rate, and the status of growth after RTx were analysed by retrospective study.
Results : Eighteen RTx were performed in 17 patients(8 boys, 9 girls). The mean age at the time of RTx was $15.8{pm}3.5$ years and the mean duration of dialysis therapy before RTx was $22.4{pm}18.0$ months. The 1 year and 5 year patient survival rate were each 100%, and the 1 year and 5 year graft survival rate were 88%, 36% respectively. The most common cause of graft failure was chronic rejection. The mean final height of male patients was $162.8{pm}10.0$ cm(143.0-172.5 cm) and of female patients was $154.5{pm}12.1$ cm(135.8-160.0 cm). The mean height standard deviation score(Ht SDS) increased after RTx from -1.95 to -1.53 but the increment rate was not statistically significant. Similar changes were noted in individual patient analysis. Also there was no significant difference between the living-related donors and cadaveric donors.
Conclusion : Our data shows that even successful RTx rarely results in full growth rehabilitation. To overcome retarded growth in children with chronic renal failure, appropriate combined management of metabolic and nutritional problems, correction of anemia, proper use of recombinant growth hormone therapy, early renal transplantation and shortening of the duration of dialysis would be necessary.
Key words: Renal transplantation | Children | Growth | Final height
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