Interfering Factors in the Growth of the Pediatric Population after Kidney Transplantation

Maria Goretti Moreira Guimarães Penido
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Abstract

Growth failure is a marked feature in children with CKD. Kidney transplantation (KTx) is the therapeutic option that provides the greatest benefits to the pediatric population. Considering the importance of this subject, a systematic search of the literature was carried out on the principal databases from January 2015 to December 2020. The following descriptors in health science (DECs) from the VHL portal (library virtual health) were applied: pediatric kidney transplantation (PKTx), growth and development. It was found that among the etiologies, congenital abnormalities of the kidneys and urinary tract (CAKUT) were the main causes of loss of renal function. The highest mean age was 15.52 ± 1.8 years. The type of donor was reported in only 3 studies, in 1 of which the living donor was predominant. The immunosuppression (ISS) schemes after PKTx were similar in the studies, the triple scheme with corticoid, calcineurin inhibitor and anti-proliferative being used in most of them. The use of GH did not occur in 4 of the 9 studies. We could conclude that weight and height gain after PKTx is an important outcome to be evaluated. In underdeveloped or developing countries where, in addition to chronic disease, we find nutritional and economic precariousness, it is very important to know the factors that greatly contribute to the impairment of height and weight gain of these patients. Controlled and randomized studies that find answers for the control of pediatric patients after PKTx and that can be applied in our country are desired.
肾移植后小儿生长发育的干扰因素
生长发育迟缓是慢性肾脏病患儿的一个显著特征。肾移植(KTx)是能为儿童带来最大益处的治疗方案。考虑到这一课题的重要性,我们从 2015 年 1 月至 2020 年 12 月在主要数据库中进行了系统的文献检索。应用了 VHL 门户网站(虚拟健康图书馆)中的以下健康科学描述符(DECs):小儿肾移植(PKTx)、生长发育。研究发现,在各种病因中,肾脏和泌尿道先天畸形(CAKUT)是导致肾功能丧失的主要原因。平均年龄最高,为 15.52±1.8 岁。只有 3 项研究报告了供体类型,其中 1 项研究以活体供体为主。这些研究中,PKTx 后的免疫抑制(ISS)方案相似,大多数都采用了皮质激素、钙神经蛋白抑制剂和抗增殖剂三联方案。在 9 项研究中,有 4 项没有使用促生长激素。我们可以得出结论,PKTx 治疗后体重和身高的增加是需要评估的重要结果。在欠发达国家或发展中国家,除了慢性疾病之外,我们还发现营养和经济方面的不稳定因素,因此了解导致这些患者身高和体重增加受阻的重要因素非常重要。我们希望进行对照和随机研究,为控制 PKTx 后的儿科患者找到答案,并将其应用于我国。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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