CSA/AZA, in the absence of prednisone, improves linear growth in renal transplanted children.
We compared the results of 44 renal transplants in children, of whom 24 were treated with CSA/AZA and 20 with prednisone in combination with AZA and/or CSA. There were no differences in age distribution or mean ages at transplant between the two treatment groups. The CSA/AZA group had a longer follow-up (29 +/- 33 vs 17 +/- 18 months). At the last follow-up, five children in the CSA/AZA and none in the prednisone group had lost their grafts. Serum creatinine increased in both groups from 0.7 +/- 0.1 mg/dl and 0.9 +/- 0.1 mg/dl at the end of the first month to 1.1 +/- 0.2 mg/dl in the 36th month (CSA/AZA group) (P < 0.0001) and to 1.5 +/- 0.6 mg/dl in the 18th month (prednisone group) (P < 0.05), respectively. Total cholesterol level was 189 +/- 52 mg/dl and 178 +/- 60 mg/dl and LDL level was 117 +/- 48 mg/dl and 115 +/- 51 mg/dl for the prednisone and CSA/AZA groups, respectively. HDL was greater in the CSA/AZA group (50 +/- 10 vs 41 +/- 10 mg/dl) (P < 0.03), and VLDL was greater in the prednisone group (31 +/- 13 vs 22 +/- 8 mg/dl) (P < 0.05). Serum triglyceride was greater in the prednisone group (174 +/- 93 vs 112 +/- 50 mg/dl) (P < 0.03). The standard deviation score for height of the children in the prednisone group did not change (-2.4 +/- 1.4 vs -2.1 +/- 1.4 SDS), whereas the SDS height score for the CSA/AZA children increased from -3.1 +/- 1.7 to -2.6 +/- 1.5, -1.9 +/- 1.4 and -1.7 +/- 1.4, at 12, 24 and 36 months, respectively (P < 0.001). CSA/AZA is a good immunosuppressive regime for the first renal transplant in children, but only 75% tolerated AZA/CSA without same damage to their grafts.
David-Neto
E
E
Unidade de Transplante Renal, Servico de Urologia, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Brazil.
Nahas
W
W
Sampaio
E C
EC
Ianhez
L E
LE
Sabbaga
E
E
Arap
S
S
D001379:Azathioprine / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects*; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006128:Growth / Q000187:drug effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000502:physiology*; D011241:Prednisone / Q000627:therapeutic use; D013997:Time Factors
D008078:Cholesterol, LDL; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine; D001379:Azathioprine; D011241:Prednisone