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Steroid withdrawal in pediatric kidney transplant allows better growth, lipids and body composition: a randomized controlled trial.

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dc.contributor.author Mericq, Verónica
dc.contributor.author Salas, Paulina
dc.contributor.author Pinto, Viola
dc.contributor.author Cano, Francisco
dc.contributor.author Reyes, Loreto
dc.contributor.author Brown, Keenan
dc.contributor.author Gonzalez, Magdalena
dc.contributor.author Michea, Luis
dc.contributor.author Delgado, Iris
dc.contributor.author Delucchi, Ángela
dc.date.accessioned 2017-04-06T15:42:13Z
dc.date.available 2017-04-06T15:42:13Z
dc.date.issued 2013
dc.identifier.citation Horm Res Paediatr. 2013;79(2):88-96 es_CL
dc.identifier.uri http://dx.doi.org/10.1159/000347024 es_CL
dc.identifier.uri http://hdl.handle.net/11447/1100
dc.description Centro de Epidemiología y Políticas de Salud es_CL
dc.description.abstract BACKGROUND: Glucocorticoid immunosuppressant therapy in pediatric kidney transplant (Tx) recipients does not allow the improvement of growth after Tx. OBJECTIVE: To determine the effect of early steroid withdrawal (SW) on longitudinal growth, insulin sensitivity (IS), and body composition (BC). METHODS: This was a prospective, randomized, multicenter study in Tx. Insulin-like growth factor (IGF)-I, IGF-binding protein 3 (IGFBP3), IS, and BC (DEXA/pQCT) were determined at baseline and up to 12 months after Tx. RESULTS: A total of 30 patients were examined; 14 patients were assigned to the SW group (7 male, 7 female; 12 in Tanner stage I) and 16 patients were assigned to the steroid control (SC) group (10 male, 6 female;12 in Tanner stage I). Their chronological age was 7.8 ± 4.3 years, height was -2.3 ± 0.99 SD scores (SDS), and body mass index -0.3 ± 1.2 SDS. After 1 year, the SW group showed an increase in height SDS (+1.2 ± 0.22 vs. +0.60 ± 0.13 SDS in the SC group, p < 0.02), lower IGFBP3 (p < 0.05), cholesterol (p < 0.05), and higher high-density lipoprotein cholesterol (p < 0.05). SW patients had lower trunk fat with no differences in IS. Only in prepubertal patients, the SW group had lower glycemia (p < 0.05), very low-density lipoprotein cholesterol (p < 0.01), triglycerides (p < 0.05), triglycerides/glycemia index (TyG; p < 0.02), and better lean mass. Both groups showed an improvement in lean mass after kidney Tx. CONCLUSIONS: SW improved longitudinal growth, lipid profile, and trunk and lean fat in Tx patients. In prepubertal recipients, the decrease in TyG suggests better IS. es_CL
dc.format.extent 1 es_CL
dc.language.iso en_US es_CL
dc.publisher Karger es_CL
dc.subject Adiposity es_CL
dc.subject Body Height es_CL
dc.subject Body Mass Index es_CL
dc.subject Cholesterol/blood es_CL
dc.subject Immunosuppressive Agents es_CL
dc.subject Kidney Transplantation es_CL
dc.subject Steroids es_CL
dc.title Steroid withdrawal in pediatric kidney transplant allows better growth, lipids and body composition: a randomized controlled trial. es_CL
dc.type Artículo es_CL


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