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Steroid minimization in pediatric renal transplantation: Early withdrawal or avoidance?
Author(s) -
Grenda Ryszard,
Webb Nicholas J. A.
Publication year - 2010
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2010.01403.x
Subject(s) - medicine , immunosuppression , adverse effect , dyslipidemia , kidney transplantation , diabetes mellitus , transplantation , intensive care medicine , pediatrics , endocrinology
Grenda R, Webb NJA. Steroid minimization in pediatric renal transplantation: Early withdrawal or avoidance?
Pediatr Transplantation 2010: 14:961–967. © 2010 John Wiley & Sons A/S. Abstract:  Clinically important adverse events associated with the use of corticosteroids post‐transplantation include hypertension, dyslipidemia, impaired glucose metabolism (including diabetes mellitus), growth retardation, bone fractures, and cosmetic problems. Over recent years, a number of studies have investigated the effect of minimizing exposure to corticosteroids in post‐transplant immunosuppression protocols in both adults and children. In pediatric patients, several different approaches have been evaluated, including late steroid withdrawal, early steroid withdrawal, and complete steroid avoidance with or without poly‐ or monoclonal antibody induction and a variety of maintenance immunosuppressants. This manuscript reviews the key studies and documents the specific clinical benefits associated with steroid minimization. The development of PTLD and bone marrow suppression has been a major safety concern in some of these studies. These studies and other adverse effects are discussed.

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