CSA/AZA, in the absence of prednisone, improves linear growth in renal transplanted children

Abstract

We compared the results of 44 renal transplants in children, of whom 24 were treated with CS A/AZA and 20 with prednisone in combination with AZA and/or CSA. There were no differences in age distribution or mean ages at transplant between the two treatment groups. The CSA/AZA group had a longer follow-up (29 ± 33 vs 17 ± 18 months). At the last follow-up, five children in the CSA/AZA and none in the prednisone group had lost their grafts. Serum creatinine increased in both groups from 0.7 ± 0.1 mg/dl and 0.9 ± 0.1 mg/dl at the end of the first month to 1.1 ± 0.2 mg/dl in the 36th month (CSA/AZA group) (P< 0.0001) and to 1.5 ± 0.6 mg/dl in the 18th month (prednisone group) (P< 0.05), respectively. Total cholesterol level was 189 ± 52 mg/dl and 178 ± 60 mg/dl and LDL level was 117 ± 48 mg/dl and 115 ± 51 mg/dl for the prednisone and CSA/AZA groups, respectively. HDL was greater in the CSA/AZA group (50 ± 10 vs 41 ± 10 mg/dl) (P<0.03), and VLDL was greater in the prednisone group (31 ± 13 vs 22 ± 8 mg/dl) (P< 0.05). Serum triglyceride was greater in the prednisone group (174 ± 93 vs 112 ± 50 mg/dl) (P<0.03). The standard deviation score for height of the children in the prednisone group did not change (-2.4 ± 1.4 vs -2.1 ± 1.4 SDS), whereas the SDS height score for the CSA/AZA children increased from -3.1 ± 1.7 to -2.6 ± 1.5, -1.9 ± 1.4 and -1.7 ± 1.4, at 12, 24 and 36 months, respectively (P< 0.001). CSA/AZA is a good immunosuppressive regime for the first renal transplant in children, but only 75% tolerated AZA/CSA without same damage to their grafts.