Growth of kidney-transplanted pediatric patients treated with sirolimus
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : David Gonzلlez & Clotilde D. Garcیa & Marta Azَcar & Simon Waller & Angel Alonso & Gema Ariceta & Natalia Mejیa & Fernando Santos
- چاپ و سال / کشور: 2011
Description
Experimental findings indicate that sirolimus (SRL) inhibits longitudinal growth by mechanisms potentially related to its inhibitory effects on both cell proliferation and expression of vascular endothelial growth factor (VEGF). The aim of this study was to investigate the growth pattern of kidney-transplanted children treated with SRL in a multicenter observational clinical study. Height, change in height SD (ؤ height) and growth velocity of pediatric patients with renal transplant were calculated at 0, 6, 12, and 24 months after starting SRL. Controls of kidney-transplanted children not treated with SRL were matched by age, gender, renal function, and dose of corticosteroids. Sixtyeight children (34 SRL, 34 controls) were enrolled in the study. Nephrotoxicity was the most frequent indication to start therapy with SRL. SRL exerted an adverse effect on growth as demonstrated by significantly lower (p<0.05) growth velocity (cm/year) and smaller change in height SD in the SRL group after 6 (4.08 vs. 6.56 and –0.05 vs. 0.14), 12 (4.44 vs. 6.11 and –0.03 vs. 0.28) and 24 (4.53 vs. 6.03 and –0.04 vs. 0.53) months of treatment. This study suggests that SRL therapy may interfere with growth of kidney-transplanted children. This undesirable effect needs to be taken into account when considering a switch to SRL and confirmed in further prospective trials including larger number of patients.
Pediatr Nephrol (2011) 26:961–966 DOI 10.1007/s00467-011-1811-3 Received: 21 September 2010 / Revised: 16 January 2011 / Accepted: 19 January 2011 / Published online: 5 March 2011
