Figure 1623

Chronic renal insufficiency and end-stage renal disease (ESRD) resulting in physical growth and sexual development well below the potential for age and gender [21]. One of the benefits of transplantation in children has been to improve the growth rate; however, this may not occur in all patients [16,22,23]. Depicted is the overall comparison between adjusted annualized growth rates by age for prevalent pediatric transplantation and dialysis patients (1990 USRDS data) [24] and the US general population (1976-1980 data from the National Center for Health Statistics) [25]. Shown are the results of a linear regression analysis of growth rates for 578 patients on dialysis and 724 transplantation recipients. Growth rates were adjusted to reflect the average characteristics of patients with ESRD at each age with regard to gender, race, ethnicity, baseline height, and duration of ESRD. At almost all ages, growth rates were higher for transplantation recipients compared with patients on dialysis; however, the degree of advantage declined with age. No pubertal growth spurt was seen in either treatment group. Although growth rates in adolescents between 15 and 18 years of age were higher than expected for both the dialysis and transplantation groups, the average height achieved at the end of the study was still lower than expected. (From Turenne and coworkers [26]; with permission.)

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