Metabolic syndrome in pediatric renal transplant recipients: Comparing early discontinuation of steroids vs. steroid group

• Published in: Pediatric transplantation Vol. 14; no. 3; pp. 351 - 357
• Main Authors: Maduram, Amy, John, Eunice, Hidalgo, Guillermo, Bottke, Ramona, Fornell, Linda, Oberholzer, Jose, Benedetti, Enrico
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2010; Blackwell
• Subjects: Biological and medical sciences; Child; Female; General aspects; Humans; Hypertension - epidemiology; Illinois - epidemiology; Immunosuppressive Agents - administration & dosage; immunosupressive treatment; Incidence; Kidney Transplantation; Lipids - blood; Male; Medical sciences; Metabolic diseases; Metabolic Syndrome - epidemiology; Miscellaneous; obesity; Other metabolic disorders; Prevalence; Retrospective Studies; Risk Factors; Steroids - administration & dosage; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Endocrinopathy; Human; Steroid; immunosupressive treatment; Corticosteroid; Obesity; Pediatrics; Interruption; Nutrition disorder; Metabolic diseases; Cardiovascular disease; Homotransplantation; Metabolic syndrome; Kidney; Treatment; Urinary system; Surgery; Graft; Early; Immunosuppressive agent; Child; Nutritional status; Comparative study; Kidney transplantation
• ISSN: 1397-3142; 1399-3046
• DOI: 10.1111/j.1399-3046.2009.01243.x

Maduram A, John E, Hidalgo G, Bottke R, Fornell L, Oberholzer J, Benedetti E. Metabolic syndrome in pediatric renal transplant recipients: Comparing early discontinuation of steroids vs. steroid group. Pediatr Transplantation 2010:14:351–357. © 2009 John Wiley & Sons A/S. :  Steroids have played a valuable role in transplantation as a treatment option. The purpose of this study is to assess the prevalence of MS in pediatric RT patients receiving SG or early SWG; SG discontinued five days after transplantation. We retrospectively reviewed 58 pediatric RT patients between 2000 and 2007. MS criterion was defined as the presence of any three of five criteria: (i) BMI >97th percentile, (ii) hypertension (SBP/DBP > 95th percentile or on medications); (iii) triglycerides > 95thpercentile, (iv) HDL cholesterol < 5th percentile, (v) fasting glucose > 100 mg/dL. Twenty‐five patients (43%) received SG and 33 patients (57%) received SWG. The prevalence of MS in SG was 68% compared to 15% in SWG. At six months and one yr after transplantation, mean serum glucose, total cholesterol, and triglycerides were significantly lower in the SWG. The prevalence of hypertension was significantly lower in the SWG, and patients in the SWG received significantly less lipid‐lowering and anti‐hypertensive medications than SG. Mean BMI percentile was significantly higher in SG one yr after transplantation but not after six months, although always significantly higher in patients with MS (p < 0.05). From this study, we conclude that for pediatric RT patients, cardiovascular risk factors are significantly lower in SG withdrawal groups.