Glucocorticoid pharmacokinetics and growth retardation in children with renal transplants.
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.
Chavatte
Claire
C
Service Pharmacie, Hôpital Necker Enfants Malades, 149 rue de Sèvres, 75015 Paris, France.
Guest
Geneviève
G
Proust
Virginie
V
Le Bihan
Christine
C
Gimenez
François
F
Maisin
Anne
A
Loirat
Chantal
C
Mogenet
Agnès
A
Bresson
Jean-Louis
JL
Hankard
Régis
R
Broyer
Michel
M
Niaudet
Patrick
P
Singlas
Eric
E
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005938:Glucocorticoids / Q000009:adverse effects* / Q000493:pharmacokinetics*; D006130:Growth Disorders / Q000139:chemically induced*; D006801:Humans; D016030:Kidney Transplantation; D011239:Prednisolone / Q000009:adverse effects* / Q000493:pharmacokinetics*; D011241:Prednisone / Q000009:adverse effects* / Q000493:pharmacokinetics*
D005938:Glucocorticoids; D011239:Prednisolone; D011241:Prednisone