Glucocorticoid pharmacokinetics and growth retardation in children with renal transplants

被引:13
作者
Chavatte, C
Guest, G
Proust, V
Le Bihan, C
Gimenez, F
Maisin, A
Loirat, C
Mogenet, A
Bresson, JL
Hankard, R
Broyer, M
Niaudet, P
Singlas, E
机构
[1] Hop Necker Enfants Malad, Serv Pharm, F-75015 Paris, France
[2] Hop Necker Enfants Malad, Ctr Invest Clin, F-75015 Paris, France
[3] Hop Robert Debre, Ctr Invest Clin, F-75019 Paris, France
关键词
glucocorticoid; growth; renal transplantation; pharmacokinetics;
D O I
10.1007/s00467-004-1497-x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Long-term glucocorticoid treatment contributes to the growth retardation in children after renal transplantation. We investigated whether determination of prednisone (PN) and prednisolone (PL) in plasma and PN, PL, and 6-beta-hydroxyprednisolone (betaOH-PL) in urine could help to predict growth. PN and PL pharmacokinetics were studied in 36 children, from 5 to 15 years of age, receiving daily (D) or alternate-day (AD) oral PN treatment. Statural growth velocity was evaluated over a 1-year period. We compared three groups of children according to the growth kinetics during the study year (catch-up, stable, or decline) for clinical and pharmacokinetic parameters. A multiple linear regression analysis was performed in order to determine pharmacokinetic parameters able to explain height 1 year after inclusion. Height at the beginning of the study, creatinine clearance, and type of D or AD treatment explained 94.2% of height variance 1 year after inclusion. Only PL clearance was associated with growth evolution, but introduction of PL clearance in the multivariate model did not improve the variance of height accounted for by the previous model. We, therefore, do not recommend using glucocorticoid pharmacokinetics to predict growth retardation in children with renal transplantation.
引用
收藏
页码:898 / 904
页数:7
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