Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: After kidney transplant (tx), children are expected to thrive, however in a subset this does not occur. Causes and implications of post-tx failure to thrive (FTT) are not well understood.
Objective: A retrospective cohort study was conducted to determine factors associated with FTT and association of FTT with adverse outcomes (hospitalization and infection).
Methods: Records of 119 children consecutively transplanted between 2005-2016 were reviewed. FTT was defined as ≥2 of the following: 1) low body mass, 2) poor weight gain 3) poor growth, or 4) chronic hypoalbuminemia at 1 or 3 years post-tx. Logistic regression was used to identify factors associated with FTT and poisson regression for association of FTT with outcomes at 1 and 3 years.
Results: Prevalence of FTT was 22% and 18% at 1 and 3 years. Factors associated with FTT shown in Table 1. Odds of FTT decreased by 0.5 for each 1 unit increase in pre-tx BMI z-score. Clean intermittent catheterization (CIC) conferred 3.8 and 7.8 times odds of FTT at 1 and 3 years. FTT at 1 year increased odds of FTT at 3 years. In patients with FTT, infections increased 2.7 and 4.2 times and hospitalizations increased 2.6 and 4.3 times at 1 and 3 years (p<0.0006).
|Table 1. Risk factors associated with FTT
|Bivariate Analysis||FTT at 1 year (n=119)||FTT at 3 years (n=84)|
|Pre-tx variables||p value||p value|
|Deceased vs. living donor||0.03**||0.50|
|Vitamin D deficiency||0.13||0.03*|
|Multivariate analysis||Odds Ratio (95%CI)|
|Pre-tx BMI z-score||0.5 (0.3-0.8)#||NS|
|CIC||3.8 (1.04-14.2)#||7.8 (1.04-58.4)#|
|FTT at 1 year||NA||61.1 (7.8-478)#|
Not significant: dialysis modality, glomerular disease, donor specific antibody, steroids, age, sex, race
#logistic regression: adjusted for age, sex, race, eGFR
Conclusion: Children with low BMI pre-tx and those requiring CIC post-tx are at increased risk for post-tx FTT. FTT is associated with adverse outcomes, evidenced by increased infection and hospitalization.
CITATION INFORMATION: Sgambat K., Cheng Y., Charnaya O., Moudgil A. Failure to Thrive after Pediatric Kidney Transplantation Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Sgambat K, Cheng Y, Charnaya O, Moudgil A. Failure to Thrive after Pediatric Kidney Transplantation [abstract]. https://atcmeetingabstracts.com/abstract/failure-to-thrive-after-pediatric-kidney-transplantation/. Accessed May 7, 2021.
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