Document Detail

A study on strategies for improving growth and body composition after renal transplantation.
MedLine Citation:
PMID:  20151158     Owner:  NLM     Status:  MEDLINE    
Allograft function and metabolic effects of four treatment regimens, namely, methylprednisone (MP) standard dose (MP-STD), deflazacort (DFZ), MP-late steroid withdrawal (MP-LSW), and MP-very low dose (MP-VLD), were evaluated in prepubertal patients. MP was decreased by month 4 post-transplantation to 0.2 mg/kg/day in MP-STD and DFZ patients and to <0.1 mg/kg/day in MP-LSW and MP-VLD patients. Starting in month 16 post-transplant, MP was switched to DFZ in the DFZ group and totally withdrawn in the MP-LSW group. Creatinine clearance diminished in the MP-STD and MP-LSW groups from 77 +/- 6 to 63 +/- 6 ml/min/1.73 m(2)and from 103 +/- 5 to 78 +/- 3 ml/min/1.73 m(2), respectively (p < 0.01 and p < 0.001, respectively). Height increased >0.5 SDS only in the MP-LSW and MP-VLD groups. The body mass index and fat body mass for height-age increased only in the MP-STD patients (p < 0.05 and p < 0.01, respectively). Fat body mass decreased in the DFZ group (p < 0.05), total cholesterol and LDL-cholesterol increased in the MP-STD group, while LDL-cholesterol and total cholesterol/HDL-cholesterol ratio decreased in the DFZ group (p < 0.01). Lumbar spine bone mineral density (BMD) for height-age showed an increase in the MP-LSW and MP-VLD groups (p < 0.01). Our data suggest that MP-LSW and MP-VLD strategies improve linear growth, BMD, the peripheral distribution of fat, and preservation of the bone-muscle unit and maintain the normal lipid profile. The MP-LSW patients had a concerning rate of acute rejections and graft function deterioration in prepubertal patients.
Jorge R Ferraris; Titania Pasqualini; Guillermo Alonso; Susana Legal; Patricia Sorroche; Ana Galich; Paula Coccia; Lidia Ghezzi; Ver?nica Ferraris; Liliana Karabatas; Clara Guida; H?ctor Jasper
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Publication Detail:
Type:  Journal Article     Date:  2010-02-12
Journal Detail:
Title:  Pediatric nephrology (Berlin, Germany)     Volume:  25     ISSN:  1432-198X     ISO Abbreviation:  Pediatr. Nephrol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-02-24     Completed Date:  2010-06-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8708728     Medline TA:  Pediatr Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  753-62     Citation Subset:  IM    
Servicio de Nefrolog?a Pedi?trica, Hospital Italiano, Buenos Aires, Argentina.
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MeSH Terms
Body Composition / physiology*
Bone Density / drug effects,  physiology
Child, Preschool
Dose-Response Relationship, Drug
Drug Administration Schedule
Graft Rejection / chemically induced
Growth / physiology*
Growth Disorders / physiopathology,  prevention & control*,  rehabilitation
Immunosuppressive Agents / therapeutic use
Kidney Transplantation / adverse effects*,  rehabilitation
Lumbar Vertebrae / drug effects,  metabolism
Methylprednisolone / therapeutic use
Postoperative Complications / prevention & control,  rehabilitation
Pregnenediones / therapeutic use
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Pregnenediones; 14484-47-0/deflazacort; 83-43-2/Methylprednisolone

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