Pediatric transplantation · 2026
Impact of Minimal Steroid Doses on Post-Transplant Growth in Pediatric Kidney Recipients, a Retrospective Observational Study.
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Ochoa-García Carolina Lucia, Villegas-Arbeláez Esteban, Peláez-Ortiz Juan Camilo, Serna-Campuzano Angelica, Rojas-Rosas Luisa Fernanda, Serna-Higuita Lina Maria, Isaza-López Maria Carolina
Аннотация
BACKGROUND: Despite the known impact of steroid therapy on growth after kidney transplantation (KTx), steroids remain widely used in pediatric KTx recipients. Evidence on the effect on linear growth at minimal doses of steroids (6 mg/m2 or 0.2 mg/kg/day) is limited. This study evaluated whether low doses of steroid therapy are associated with post-transplant growth failure.
METHODS: Single-center retrospective cohort study. In total, 44 pediatric KTx recipients from 2005 to 2024 were collected. Differences in Z-Score and height before 6 months and after 6 and 12 months of KTx were assessed using Friedman rank tests. Linear mixed models were used to analyze the longitudinal effect of steroid therapy on growth outcomes.
RESULTS: The mean age at KTx was 11 years (SD ± 3.8). Median prednisolone doses at 3 and 6 months after KTx were 0.23 (p25-75: 0.18-0.41) and 0.21 mg/k/day (0.14-0.28), respectively. The mean-height Z-score improved from -2.35 (SD ± 1.30) to 1.82 (SD ± 1.23) one year post-KTx. The percentage of patients with short stature (height Z-score ≤ -2SD) decreased from 65.1% at baseline (KTx) to 54.8% and 52.3% after 6 and 12 months, respectively. In multivariable analysis, time follow-up and age at KTx were associated with post-transplant growth. Steroid therapy shows a trend to reduce body height, but the interaction was not significant.
CONCLUSION: This single-center study found that pediatric KTx recipients receiving low-dose steroid therapy showed post-transplant improvements in height and Z-scores. Notably, the use of low-dose steroids did not significantly impair growth, although a slight downward trend in Z scores was noted.
METHODS: Single-center retrospective cohort study. In total, 44 pediatric KTx recipients from 2005 to 2024 were collected. Differences in Z-Score and height before 6 months and after 6 and 12 months of KTx were assessed using Friedman rank tests. Linear mixed models were used to analyze the longitudinal effect of steroid therapy on growth outcomes.
RESULTS: The mean age at KTx was 11 years (SD ± 3.8). Median prednisolone doses at 3 and 6 months after KTx were 0.23 (p25-75: 0.18-0.41) and 0.21 mg/k/day (0.14-0.28), respectively. The mean-height Z-score improved from -2.35 (SD ± 1.30) to 1.82 (SD ± 1.23) one year post-KTx. The percentage of patients with short stature (height Z-score ≤ -2SD) decreased from 65.1% at baseline (KTx) to 54.8% and 52.3% after 6 and 12 months, respectively. In multivariable analysis, time follow-up and age at KTx were associated with post-transplant growth. Steroid therapy shows a trend to reduce body height, but the interaction was not significant.
CONCLUSION: This single-center study found that pediatric KTx recipients receiving low-dose steroid therapy showed post-transplant improvements in height and Z-scores. Notably, the use of low-dose steroids did not significantly impair growth, although a slight downward trend in Z scores was noted.