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

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dc.contributor.authorMericq, Verónica
dc.contributor.authorSalas, Paulina
dc.contributor.authorPinto, Viola
dc.contributor.authorCano, Francisco
dc.contributor.authorReyes, Loreto
dc.contributor.authorBrown, Keenan
dc.contributor.authorGonzalez, Magdalena
dc.contributor.authorMichea, Luis
dc.contributor.authorDelgado, Iris
dc.contributor.authorDelucchi, Ángela
dc.date.accessioned2017-04-06T15:42:13Z
dc.date.available2017-04-06T15:42:13Z
dc.date.issued2013
dc.descriptionCentro de Epidemiología y Políticas de Salud
dc.description.abstractBACKGROUND: 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.
dc.format.extent1
dc.identifier.citationHorm Res Paediatr. 2013;79(2):88-96
dc.identifier.urihttp://hdl.handle.net/11447/1100
dc.identifier.urihttp://dx.doi.org/10.1159/000347024
dc.language.isoen_US
dc.publisherKarger
dc.subjectAdiposity
dc.subjectBody Height
dc.subjectBody Mass Index
dc.subjectCholesterol/blood
dc.subjectImmunosuppressive Agents
dc.subjectKidney Transplantation
dc.subjectSteroids
dc.titleSteroid withdrawal in pediatric kidney transplant allows better growth, lipids and body composition: a randomized controlled trial.
dc.typeArtículo

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