Complications of chronic kidney disease in children post-renal transplantation - A single center experience
Complications of chronic kidney disease in children post-renal transplantation - A single center experience
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DOI：
10.1111/j.1399-3046.2007.00782.x
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发表时间：
2008-02-01
影响因子：
1.3
通讯作者：
Filler, Guido
中科院分区：
文献类型：
--
作者：
Feber, Janusz;Wong, Hubert;Filler, Guido
与成人相似，CKD可能在儿科RTx后持续存在。回顾性分析了23例RTx受者（13例男性，年龄11.9 ± 5.2岁）的临床和实验室参数，这些受者在RTx后4个月（T1）和RTx后3.4 ± 2.8年（T2）最初接受泼尼松、钙调磷酸酶抑制剂（TAC = 18，环孢霉素neoral = 5）和MMF治疗。平均值（+/-标准差）半胱氨酸蛋白酶抑制剂C GFR（mL/min/1.73 m（2））在T1时为72 +/- 19，在T2时为70 +/- 22（NS）。T2时，5例患者（22%）为CKD I期，8例患者（35%）为II期，10例患者（43%）为III期。在T2时，19例患者使用钙调磷酸酶抑制剂，13例患者使用MMF，13例患者使用SIR。T1时高血压患病率为69%，T2时为87%（p = NS）。T1和T2时分别有61%和69%的患者诊断为贫血，平均治疗MMF（2.78 +/- 1.3 mg/mL）和SIR（7.62 +/- 2.3 mg/mL）谷水平。在T1和T2时分别有44.0%和47%的患者检测到高胆固醇血症。T1和T2时分别有26.0%和21.7%的患者诊断为骨病。平均身高Z评分为-1.0 +/- 1.2（T1）和-1.0 +/- 1.59（T2，NS），T1时21%和T2时30%的患者低于2个SDS。我们观察到，在相当一部分移植儿童中，生长欠佳、高血压、高胆固醇血症、骨病和贫血。
Similar to adults, CKD may persist after pediatric RTx. Clinical and laboratory parameters were analyzed retrospectively in 23 RTx recipients (13 males, age 11.9 +/- 5.2 yr), initially treated with prednisone, calcineurin inhibitor (TAC = 18, cyclosporine neoral = 5), and MMF at four months post-RTx (T1) and at 3.4 +/- 2.8 yr post-RTx (T2). Mean (+/- s.d.) cystatin C GFR (mL/min/1.73 m(2)) was 72 +/- 19 at T1 and 70 +/- 22 at T2 (NS). At T2, CKD stage I was present in five patients (22%), stage II in eight patients (35%), and stage III in 10 patients (43%). At T2, calcineurin inhibitors were utilized in 19, MMF in 13, and SIR in 13 patients. The prevalence of hypertension was 69% at T1 and 87% at T2 (p = NS). Anemia was diagnosed in 61% at T1 and 69% at T2 with average therapeutic MMF (2.78 +/- 1.3 mg/mL) and SIR (7.62 +/- 2.3 mg/mL) trough levels. Hypercholesterolemia was detected in 44.0% at T1 and 47% at T2. Bone disease was diagnosed in 26.0% at T1 and 21.7% at T2. Mean height Z-scores were -1.0 +/- 1.2 (T1) and -1.0 +/- 1.59 (T2, NS), with 21% at T1 and 30% at T2 below two SDS. We observed suboptimal growth, hypertension, hypercholesterolemia, bone disease, and anemia in a significant proportion of transplanted children.