ESPN 51th Annual Meeting

ESPN 2018

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


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.


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). 


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.