Children's Hospital, Technical University Munich, Munich, Germany.
Transpl Int. 2012 Mar;25(3):276-82. doi: 10.1111/j.1432-2277.2011.01400.x. Epub 2011 Dec 21.
Long-term corticosteroid treatment impairs growth in children after kidney transplantation (KTx). The impact of steroid withdrawal with respect to adult height remains to be elucidated. In this single-center retrospective analysis linear growth and graft function in 74 pediatric KTx patients transplanted between 1981 and 2001 was investigated. Mean follow up was 8.5years. Steroids were weaned off between months 4 and 6. Steroid withdrawal resulted in sustained catch-up growth after KTx. Absolute and standardized height velocity in prepubertal patients during the first year post-KTx was 8.9cm/year and +2.9 SD score (SDS), respectively (P<0.001 versus healthy children). Mean adult height amounted to -0.5±1.1 SDS and -1.0±1.3 SDS in prepubertal and pubertal patients and was within the normal range (>-2 SD) in 94% and 80% of them. Multiple regression analysis revealed age and standardized height at KTx as independent predictors of adult height (model r(2) =0.48). Overall graft survival at 5 and 10years was 92% and 71%, respectively. Steroid withdrawal during month 4-6 after KTx in prepubertal patients results in an adult height within the normal range, whereas catch-up growth is limited in pubertal patients.
长期皮质类固醇治疗会损害肾移植（KTx）后儿童的生长。关于成人身高，皮质类固醇停药的影响仍需阐明。在这项单中心回顾性分析中，研究了 1981 年至 2001 年间接受 KTx 的 74 例儿科 KTx 患者的线性生长和移植物功能。平均随访时间为 8.5 年。皮质类固醇在 4 至 6 个月之间逐渐减少。KTx 后，皮质类固醇停药导致持续追赶生长。在 KTx 后第一年，青春期前患者的绝对和标准化身高速度分别为 8.9cm/年和+2.9 SD 评分（SDS）（P<0.001 与健康儿童相比）。青春期前和青春期患者的平均成人身高为-0.5±1.1 SDS 和-1.0±1.3 SDS，其中 94%和 80%的患者在正常范围内（>-2 SDS）。多元回归分析显示，年龄和 KTx 时的标准化身高是成人身高的独立预测因子（模型 r(2) =0.48）。5 年和 10 年时的总移植物存活率分别为 92%和 71%。在 KTx 后 4-6 个月的青春期前患者中逐渐减少皮质类固醇可使成人身高在正常范围内，而追赶生长在青春期患者中受到限制。
