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Status: Bibliographieeintrag

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Verfasst von:Höcker, Britta [VerfasserIn]   i
 Weber, Lutz T. [VerfasserIn]   i
 Feneberg, Reinhard [VerfasserIn]   i
 Drube, Jens [VerfasserIn]   i
 John, Ulrike [VerfasserIn]   i
 Fehrenbach, Henry [VerfasserIn]   i
 Pohl, Martin [VerfasserIn]   i
 Zimmering, Miriam [VerfasserIn]   i
 Fründ, Stefan [VerfasserIn]   i
 Klaus, Günter [VerfasserIn]   i
 Wühl, Elke [VerfasserIn]   i
 Tönshoff, Burkhard [VerfasserIn]   i
Titel:Improved growth and cardiovascular risk after late steroid withdrawal
Titelzusatz:2-year results of a prospective, randomised trial in paediatric renal transplantation
Verf.angabe:Britta Höcker, Lutz T. Weber, Reinhard Feneberg, Jens Drube, Ulrike John, Henry Fehrenbach, Martin Pohl, Miriam Zimmering, Stefan Fründ, Günter Klaus, Elke Wühl and Burkhard Tönshoff
E-Jahr:2010
Jahr:[February 2010]
Umfang:8 S.
Illustrationen:Diagramme
Fussnoten:Published: 30 September 2009 ; Gesehen am 24.05.2023
Titel Quelle:Enthalten in: Nephrology, dialysis, transplantation
Ort Quelle:Oxford : Oxford Univ. Press, 1986
Jahr Quelle:2010
Band/Heft Quelle:25(2010), 2 vom: Feb., Seite 617-624
ISSN Quelle:1460-2385
Abstract:Background. Long-term corticosteroid treatment impairs growth and increases cardiovascular risk factors. Hence, steroid withdrawal constitutes a major topic in paediatric renal transplantation and maintenance immunosuppression. Methods. The lack of data from randomised controlled trials caused us to conduct the first prospective, randomised, multicentre study on late steroid withdrawal among paediatric kidney allograft recipients treated with standard-dose cyclosporine microemulsion (CsA) and mycophenolate mofetil (MMF) for 2 years. Forty-two low- or regular-immunologic risk patients were randomly assigned, ≥1 year post-transplant, to continue taking or to withdraw steroids over 3 months. Results. Two years after steroid withdrawal, they showed a longitudinal growth superior to controls [mean height standard deviation score (SDS) gain, 0.6 ± 0.1 SDS versus −0.2 ± 0.1 SDS ( P < 0.001)]. The prevalence of the metabolic syndrome declined significantly ( P < 0.05), 2 years after steroid withdrawal, from 39% (9/23) to 6% (1/16). Steroid-free patients had less frequent arterial hypertension (50% versus 93% ( P < 0.05)) and required fewer antihypertensive drugs [0.6 ± 0.2 versus 1.5 ± 0.3 ( P < 0.05 versus control)]. Additionally, they had a significantly improved carbohydrate and lipid metabolism with fewer hypercholesterolaemia and hypertriglyceridaemia ( P < 0.05 versus control). Patient and graft survival amounted to 100%. Allograft function remained stable 2 years after steroid withdrawal. The incidence of acute rejections was similar in the steroid-withdrawal group (1/23, 4%) and controls (2/19, 11%). Conclusion. Late steroid withdrawal in selected CsA- and MMF-treated paediatric kidney transplant recipients improves growth, mitigates cardiovascular risk factors and reduces the prevalence of the metabolic syndrome, at no increased risk of acute rejection or unstable graft function.
DOI:doi:10.1093/ndt/gfp506
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1093/ndt/gfp506
 DOI: https://doi.org/10.1093/ndt/gfp506
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1846072654
Verknüpfungen:→ Zeitschrift

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