title: Normal adult height after steroid-withdrawal within 6 months of pediatric kidney transplantation: a 20 years single center experience.
abstract: Long-term corticosteroid treatment impairs growth in children after kidney transplantation (KTx). The impact of steroid withdrawal with respect to adult height remains to be elucidated. In this single-center retrospective analysis linear growth and graft function in 74 pediatric KTx patients transplanted between 1981 and 2001 was investigated. Mean follow up was 8.5years. Steroids were weaned off between months 4 and 6. Steroid withdrawal resulted in sustained catch-up growth after KTx. Absolute and standardized height velocity in prepubertal patients during the first year post-KTx was 8.9cm/year and +2.9 SD score (SDS), respectively (P<0.001 versus healthy children). Mean adult height amounted to -0.5±1.1 SDS and -1.0±1.3 SDS in prepubertal and pubertal patients and was within the normal range (>-2 SD) in 94% and 80% of them. Multiple regression analysis revealed age and standardized height at KTx as independent predictors of adult height (model r(2) =0.48). Overall graft survival at 5 and 10years was 92% and 71%, respectively. Steroid withdrawal during month 4-6 after KTx in prepubertal patients results in an adult height within the normal range, whereas catch-up growth is limited in pubertal patients.
authors.affiliation: Children's Hospital, Technical University Munich, Munich, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Klare
authors.forename: Carmen R
authors.initials: CR
authors.lastname: Montoya
authors.forename: Dagmar-C
authors.initials: DC
authors.lastname: Fischer
authors.forename: Manfred J
authors.initials: MJ
authors.lastname: Stangl
authors.forename: Dieter
authors.initials: D
authors.lastname: Haffner
mesh_terms: D000293:Adolescent; D000328:Adult; D001827:Body Height / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006084:Graft Rejection / Q000517:prevention & control; D006085:Graft Survival; D006130:Growth Disorders / Q000139:chemically induced*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007223:Infant; D016030:Kidney Transplantation; D016014:Linear Models; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011627:Puberty; D012189:Retrospective Studies; D028761:Withholding Treatment; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011239:Prednisolone