EFFECTS OF DEFLAZACORT IMMUNOSUPPRESSION ON LONG-TERM GROWTH AND GROWTH-FACTORS AFTER RENAL-TRANSPLANTATION

Deflazacort is an oxazoline compound derived from prednisolone. We stu died changes in kidney function, growth velocity, weight/height ratio, insulin-like growth factor (IGF-I), and IGF binding proteins before a nd after substitution of deflazacort for methylprednisone in 27 transp lanted patients aged 3.1-20 years. Methylprednisone (mean +/- SEM 0.17 +/- 0.01 mg/kg per day) was replaced by deflazacort (0.29 +/- 0.01 mg /kg per day) for a period of 1-5 years. Calculated creatinine clearanc e did not change significantly during deflazacort treatment. Growth ve locity increased from 2.6 +/- 0.5 cm/year to 5.2 +/- 0.7 cm/year (1st year) in 14 prepubertal patients. After 4 years of deflazacort treatme nt, height standard deviation score for chronological age did not chan ge in 7 prepubertal patients. Mean weight/height ratio decreased by 50 % (1st year) and remained reduced during follow-up. Serum IGF-I, IGF b inding protein -3 (IGFBP3), IGF/IGFBP3 molar ratio, and IGF-I and -II binding capacities showed no significant change; however in 5 of 6 pat ients IGFBP2 decreased during deflazacort therapy. Our findings sugges t that immunosuppressive treatment with deflazacort is as effective as methylprednisone and may lead to an improvement in the growth prognos is of children with renal transplantation.