The growth of every child with a bone age less than 15 years who received a first renal transplant between 1975 and 1980 was analysed to determine the growth expectation of children with renal transplants substantially maintained on alternate-day prednisolone. Growth was expressed as a standard deviation score defined as the difference between the standard deviation for height at the time of the transplant and at the end of 1981. Average growth achieved by the 46 children. 41 with functioning transplants, was normal with a mean standard deviation score of +0.7 +/- 0.3 (SEM) for boys and -0.3 +/- 0.3 (SEM) for girls; 25 of the children had accelerated growth. Mean standard deviation scores per year of advance of bone age in 29 children was +0.003, which suggested no overall loss of growth potential. No difference in growth per year of advance in bone age was detected in children with a bone age less than 12 years at transplant compared with more mature children, but boys with a bone age less than 12 years grew better per year of advance in chronological age; this appeared to be related at least in part to their greater growth deficit at transplant. Glomerular filtration rate, alternate-day prednisolone dose, and level of plasma phosphate did not appear to affect growth in the 11 prepubertal children with functioning first grafts.
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