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

Veronica Mericq1, Paulina Salas, Viola Pinto

  • 1Institute of Maternal and Child Research, University of Chile, Santiago, Chile.

Hormone Research in Paediatrics
|February 23, 2013
PubMed

Insights

Early steroid withdrawal in pediatric kidney transplant patients significantly improves growth and body composition. This approach enhances lipid profiles and, in prepubertal children, suggests better insulin sensitivity.

Area of Science:

  • Pediatric Nephrology
  • Immunosuppression Therapy
  • Transplantation Medicine

Background:

  • Glucocorticoid immunosuppressants hinder growth in pediatric kidney transplant recipients.
  • Optimizing post-transplant outcomes requires addressing growth and metabolic complications.

Purpose of the Study:

  • To evaluate the impact of early steroid withdrawal (SW) on growth, insulin sensitivity (IS), and body composition (BC) in pediatric kidney transplant patients.
  • To compare outcomes between early SW and standard steroid treatment.

Main Methods:

  • Prospective, randomized, multicenter study involving pediatric kidney transplant recipients.
  • Assessed Insulin-like Growth Factor (IGF)-I, IGF-binding protein 3 (IGFBP3), IS, and BC (DEXA/pQCT) at baseline and 12 months post-transplant.

Main Results:

  • Early SW group showed significantly greater height SDS increase compared to steroid control (SC) group (+1.2 vs. +0.60).
  • SW patients exhibited improved lipid profiles (lower cholesterol, higher HDL) and reduced trunk fat.
  • Prepubertal SW recipients demonstrated lower glycemia, triglycerides, and improved lean mass and insulin sensitivity (lower TyG index).

Conclusions:

  • Early steroid withdrawal enhances longitudinal growth, lipid profiles, and body composition in pediatric kidney transplant recipients.
  • SW may improve insulin sensitivity in prepubertal recipients, indicated by a reduced triglycerides/glycemia index.
Abstract

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