ESPN 51th Annual Meeting

ESPN 2018


 
Serum creatinine and growth in Cystinosis transplant patients – a review of NAPRTCS database
EWA ELENBERG 1

1- BAYLOR COLLEGE OF MEDICINE
 
Introduction:

NAPRTCS registry was stablished in 1987 to study North American transplant patients.

Material and methods:

Retrospective analysis of NAPRTCS database of transplanted cystinosis patients (Cys) compared to other non-recurrent, non-immunologic (NIC) forms of potential graft loss. Specific aims were to investigate potential differences in creatinine levels, growth and weight gain within 60 months (mo) post transplant.

Results:

3075 registered renal transplant patients met inclusion criteria: 2844 NIC and 231 Cys. Data was collected in 6mo interval from baseline at 30 days post transplant (p/Tx) to 60mo p/Tx. Creatinine level at baseline was similar between comparison groups, at mean 1.3mg/dl for NIC and 1.2mg/dl in Cys, improving to lowest mean at 1mg/dl in NIC and 0.9mg/dl in Cys at 6mo p/Tx. At 60mo p/Tx mean creatinine was 1.4mg/dl for NIC and 1.3mg/dl for Cys. Comparing growth, baseline height Z-Score was low in both groups: in NIC mean Z-Score was -2 and in Cys mean Z-Score was – 3.39 (p-value<0.001).  Comparing height Z-Scores at intervals 6mo p/Tx, even though the Z-Score at 60mo p/TX improved to mean -1.84 in NIC, versus -2.92 in Cys, still the difference remains statistically significant.  Height Z-Score change from baseline to 6mo p/Tx is similar between 2 groups at mean 0.1, remaining statistically significant through 60mo p/Tx: at NIC mean Z-Score change 0.33 and Cys mean Z-Score change 0.81 (p-value <0.001).  Weight Z-Score between 2 groups is also statistically significant with baseline mean -1.22 for NCI versus -2.59 for Cys. Although weight Z-Score is gradually improving over time in both groups, at 60mo p/Tx mean Z-Score for NIC is -0.33 versus Cys -1.68 (p-value <0.001). 

Conclusions:

Serum creatinine levels in NIC versus Cys are not statistically different within 60mo of transplant. Growth and weight Z-Scores although improved over time, remained statistically different between 2 groups.