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Selective late steroid withdrawal after renal transplantation


Laube, Guido F; Falger, Jutta; Kemper, Markus J; Zingg-Schenk, Andrea; Neuhaus, Thomas J (2007). Selective late steroid withdrawal after renal transplantation. Pediatric Nephrology, 22(11):1947-1952.

Abstract

Steroid withdrawal (SW) after paediatric renal transplantation (RTPL) is controversial. Selective late SW has been performed in our unit since 1995. The safety and effects of SW were analysed retrospectively in 47 patients undergoing RTPL between 1995 and 2004. Initial immunosuppression consisted of cyclosporine A, azathioprine or mycophenolate mofetil and steroids. Criteria for SW were: (1) stable renal function, (2) time interval after RTPL ≥ 1year, (3) no rejection or time interval after last rejection ≥ 1year and (4) good compliance. SW was performed in 30 patients at an age of 13.5years (range 4.5-18.5) and 2.2years (range 1-6.6) after RTPL. After SW, one patient experienced a steroid-sensitive rejection. Follow-up after SW (1.3year; range 0.25-7.5) showed maintained renal function: glomerular filtration rate at SW and currently was 82 (65-128) and 82 (42-115) ml/min per 1.73m2, respectively. The number of patients on antihypertensive treatment did not significantly change (at SW: n = 15; currently: n = 11). Height and body mass index (BMI) remained stable: Median standard deviation score (SDS) for height/BMI at SW and currently was −1.1/0.2 and −0.8/0.1, respectively. Selective late SW was safe regarding renal function and had no significant effect on blood pressure and growth

Abstract

Steroid withdrawal (SW) after paediatric renal transplantation (RTPL) is controversial. Selective late SW has been performed in our unit since 1995. The safety and effects of SW were analysed retrospectively in 47 patients undergoing RTPL between 1995 and 2004. Initial immunosuppression consisted of cyclosporine A, azathioprine or mycophenolate mofetil and steroids. Criteria for SW were: (1) stable renal function, (2) time interval after RTPL ≥ 1year, (3) no rejection or time interval after last rejection ≥ 1year and (4) good compliance. SW was performed in 30 patients at an age of 13.5years (range 4.5-18.5) and 2.2years (range 1-6.6) after RTPL. After SW, one patient experienced a steroid-sensitive rejection. Follow-up after SW (1.3year; range 0.25-7.5) showed maintained renal function: glomerular filtration rate at SW and currently was 82 (65-128) and 82 (42-115) ml/min per 1.73m2, respectively. The number of patients on antihypertensive treatment did not significantly change (at SW: n = 15; currently: n = 11). Height and body mass index (BMI) remained stable: Median standard deviation score (SDS) for height/BMI at SW and currently was −1.1/0.2 and −0.8/0.1, respectively. Selective late SW was safe regarding renal function and had no significant effect on blood pressure and growth

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Item Type:Journal Article, refereed, original work
Communities & Collections:National licences > 142-005
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:28 September 2007
Deposited On:11 Dec 2018 18:12
Last Modified:25 Apr 2019 13:05
Publisher:Springer
ISSN:0931-041X
OA Status:Green
Publisher DOI:https://doi.org/10.1007/s00467-007-0576-1
Related URLs:https://www.swissbib.ch/Search/Results?lookfor=nationallicencespringer101007s0046700705761 (Library Catalogue)
PubMed ID:17874140

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