Growth and development following paediatric kidney transplantation: Mechanisms, influencing factors, and clinical management

Table 1 Representative studies relevant to post-transplant growth and development in paediatric kidney transplantation

Ref.	Design/population	Domain	Key findings relevant to growth	Main implication
Yu et al[4], 2025	Single-centre cohort; paediatric kidney transplant recipients in China	Long-term growth outcomes	Height-for-age z-score improved after transplantation; transplant age and height at transplantation influenced later stature	Supports early transplantation and long-term graft preservation
Noguchi et al[28], 2022	Retrospective single-centre cohort; 60 transplants	Catch-up growth	Catch-up growth was more likely in younger recipients and was negatively affected by rejection episodes	Age at transplantation and rejection control matter for growth recovery
Kizilbash et al[23], 2022	Review of steroid avoidance/withdrawal strategies	Immunosuppression	Steroid minimisation did not consistently increase acute rejection in modern regimens and was associated with better growth and metabolic profiles	Favours steroid-sparing protocols in suitable low-risk children
Tourlamain et al[43], 2023	Paediatric kidney transplant recipients	Corticosteroid exposure	Early corticosteroid withdrawal was associated with improved adult height outcomes	Cumulative steroid exposure remains clinically relevant for linear growth
Jagodzinski et al[48], 2022	Prospective two-centre paediatric cohort	Growth hormone	Pre-transplant rhGH treatment was associated with superior post-transplant anthropometric outcomes	rhGH may be beneficial in selected children with persistent growth failure
Stabouli et al[51], 2022	Clinical practice recommendations	Nutrition/metabolic risk	Obesity, metabolic syndrome, and cardiometabolic risk require structured assessment and management after transplantation	Growth promotion should be integrated with cardiometabolic surveillance
Prytuła et al[81], 2025	Paediatric kidney transplant recipients	Metabolic acidosis	Growth is multifactorial; correction of metabolic acidosis alone is unlikely to fully restore linear growth	Metabolic management should complement, not replace, broader growth strategies
Selected studies[57,61,62,70]	Biomarker and machine-learning literature	Monitoring/prediction	Emerging biomarkers and predictive models are promising but focus mainly on rejection or graft outcomes rather than validated growth-specific endpoints	Routine use for growth-focused care still requires further validation

rhGH: Recombinant human growth hormone.