GROWTH AFTER RENAL-TRANSPLANTATION - AN UPDATE

被引:27
作者
OFFNER, G
ASCHENDORFF, C
BRODEHL, J
机构
[1] Kinderklinik, Medizinische Hochschule Hannover, Hannover 61, D-3000
关键词
POSTTRANSPLANT GROWTH; CYCLOSPORINE-A; AZATHIOPRINE; PREDNISOLONE; ADULT HEIGHT;
D O I
10.1007/BF01453684
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Several factors influencing post-transplant growth were analysed in a total of 163 children receiving transplants at the Medical School Hannover. Statural height at the time of transplantation depended on the length of the pre-transplant period of chronic renal failure, and was more retarded in children with congenital renal diseases than in those with acquired diseases. The retardation of bone age correlated significantly with the degree of growth retardation. The immunosuppressive regimen of cyclosporine A (CyA) and low-dose prednisolone was followed by significantly better growth rates than azathioprine (Aza) plus high-dose prednisolone. In 22 prepubertal children receiving CyA, poor graft function with a glomerular filtration rate below 40 ml/min per 1.73 m2 inhibited catch-up growth. The final height of 20 grown-up transplant recipients was found to be in the lower range of normal. A comparison of conventional and CyA treatment showed that adult height in the CyA group was higher than in the Aza group due to a significantly higher growth velocity.
引用
收藏
页码:472 / 476
页数:5
相关论文
共 37 条
[1]  
Broyer M., Growth in children with renal insufficiency, Pediatr Clin North Am, 29, pp. 991-1003, (1982)
[2]  
Betts P.R., White R.H.R., Growth potential and skeletal maturity in children with chronic renal insufficiency, Nephron, 16, pp. 325-332, (1976)
[3]  
Potter D., Greifer I., Statural growth of children with renal disease, Kidney Int, 14, pp. 334-339, (1978)
[4]  
So S.K.S., Chang P.N., Najarian J.S., Mauer S.M., Simmons R.L., Nevins T.E., Growth and development in infants after renal transplantation, J Pediatr, 110, pp. 343-350, (1987)
[5]  
Potter D., Feduska N., Melzer J., Garovoy M., Hopper S., Duca R., Salvatierra O., Twenty years of renal transplantation in children, Pediatrics, 77, pp. 465-470, (1986)
[6]  
Brodehl J., Offner G., Hoyer P.F., Schirg E., Ringe B., Pichlmayr R., Wonigeit K., Cyclosporine A in pediatric kidney transplantation and its effect on post-transplantational growth, Nephron, 44, pp. 26-31, (1986)
[7]  
Chantler C., Broyer M., Donckewolcker R.A., Brynger H., Brunner F.P., Jakobs C., Kramer P., Selwood N.H., Growth and rehabilitation of long-term survivors of treatment for end-stage renal failure in childhood, Proc Eur Dial Transplant Assoc, 18, pp. 329-339, (1981)
[8]  
Grushkin C.M., Fine R.N., Growth in children and adolescents following renal transplantation, Am J Dis Child, 121, pp. 514-516, (1973)
[9]  
McEnery P.T., Gonzales I.F., Martin L.W., West C.D., Growth and development of children with renal transplantation. Use of alternateday steroid therapy, J Pediatr, 83, pp. 806-814, (1973)
[10]  
Fine R.N., Malekzadeh M.H., Pennisi A.J., Ettinger R.B., Uittenbogaart C., Negrete V.F., Korsch B.M., Long-term results of renal transplantation in children, Pediatrics, 61, pp. 641-650, (1978)