GROWTH AFTER RENAL-TRANSPLANTATION - CORRELATION WITH IMMUNOSUPPRESSIVE THERAPY

被引：35
作者：
GUEST, G
BROYER, M
机构：
[1] Department of Paediatric Nephrology, Unité de Recherche INSERM U 192, Hôpital des Enfants-Malades, Paris Cedex 15, F-75743
来源：
PEDIATRIC NEPHROLOGY | 1991年 / 5卷 / 01期
关键词：
RENAL TRANSPLANTATION; GROWTH; IMMUNOSUPPRESSION;
D O I：
10.1007/BF00852872
中图分类号：
R72 [儿科学];
学科分类号：
100202 ;
摘要：
The growth data for children transplanted between 1973 and 1987 were analysed according to their immunosuppressive regimen. All patients treated before 1985 received conventional treatment (prednisone, azathioprine); 37% of the prepubertal children with a follow-up of longer than 2 years showed catch-up growth, and 30% of the pubertal children exhibited a normal adolescent growth spurt. Reduced renal function and corticosteroid treatment are the two main causes of growth delay. The children transplanted between January 1985 and September 1987 were given either triple therapy [cyclosporine (CsA), prednisone, azathioprine] or conventional treatment after randomisation. Growth data were significantly better with CsA. The mean height gain for prepubertal children was +0.24 SD/year on triple therapy and +0.14 SD/year on conventional therapy during the 1st year after transplantation; and 0.4 SD/year and 0 SD/year during the 2nd year (P < 0.05). The mean height gain for pubertal children was 5.6 cm/year on triple therapy and 3.6 cm/year on conventional therapy (P < 0.005). The patients on triple therapy also received a significantly lower cumulative dose of prednisone. Some selected patients on triple therapy were taken off prednisone 12 months after transplantation. All patients showed catch-up growth (+0.83 SD/year in prepubertal children, 7.2 cm/year in pubertal children). In conclusion, protocols including CsA and the lower cumulative dose of steroid (with alternate-day or even steroid withdrawal) allow the best restoration of growth.
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页码：143 / 146
页数：4
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