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Impact of Minimal Steroid Doses on Post-Transplant Growth in Pediatric Kidney Recipients, a Retrospective

Ochoa-García Carolina Lucia1,2,3,4, Villegas-Arbeláez Esteban4,5,6, Peláez-Ortiz Juan Camilo7

  • 1Pediatric Department, University of Antioquia, Medellín, Colombia.

Pediatric Transplantation
|December 22, 2025
PubMed

Insights

Low-dose steroid therapy in pediatric kidney transplant recipients did not significantly impair growth, with some patients showing improved height Z-scores post-transplant. This suggests minimal steroid doses may be safe for linear growth in this population.

Area of Science:

  • Pediatric Nephrology
  • Transplantation Immunology
  • Growth and Development

Background:

  • Steroid therapy is commonly used in pediatric kidney transplant (KTx) recipients despite known growth impacts.
  • Limited evidence exists on the linear growth effects of minimal steroid doses (≤0.2 mg/kg/day).
  • This study investigates the association between low-dose steroid therapy and post-transplant growth failure in children.

Purpose of the Study:

  • To evaluate the impact of low-dose steroid therapy on linear growth in pediatric kidney transplant recipients.
  • To determine if minimal steroid doses are associated with post-transplant growth failure.
  • To assess changes in height and Z-scores in relation to steroid use after KTx.

Main Methods:

  • Retrospective, single-center cohort study of 44 pediatric KTx recipients (2005-2024).
  • Assessed height Z-scores before and at 6, 12 months post-KTx using Friedman rank tests.
  • Analyzed longitudinal growth outcomes with linear mixed models, focusing on steroid dose (mg/kg/day).

Main Results:

  • Mean height Z-score improved from -2.35 at baseline to 1.82 one year post-KTx.
  • Short stature prevalence decreased from 65.1% to 52.3% at 12 months post-KTx.
  • Low-dose steroid therapy showed a non-significant trend towards reduced height, with time and age at KTx being significant growth factors.

Conclusions:

  • Pediatric KTx recipients on low-dose steroids demonstrated improved post-transplant height and Z-scores.
  • Minimal steroid doses did not significantly impede growth, despite a slight downward trend in Z-scores.
  • Low-dose steroid regimens appear safe for linear growth in pediatric kidney transplant survivors.
Abstract

Keywords:
body heightglucocorticoidsgrowth disorderskidney transplantpediatrics

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