Abstract:
:Calcineurin inhibitors post-renal transplantation are recognized to cause tubulopathies in the form of hyponatremia, hyperkalemia, and acidosis. Sodium supplementation may be required, increasing medication burden and potentially resulting in poor compliance. Fludrocortisone has been beneficial in addressing tubulopathies in adult studies, with limited paediatric data available. A retrospective review of data from an electronic renal database from December 2014 to January 2016 was carried out. Forty-seven post-transplant patients were reviewed with 23 (49%) patients on sodium chloride or bicarbonate. Nine patients, aged 8.3 years (range 4.9-16.4), commenced fludrocortisone 22 months (range 1-80) after transplant and were followed up for 9 months (range 2-20). All patients stopped sodium bicarbonate; all had a reduction or no increase in total daily doses of sodium chloride. Potassium levels were significantly lower on fludrocortisone, 5.2 vs 4.5 mmol/L, P = .04. No difference was noted in renal function (eGFR 77.8 vs 81.7 mL/min/1.73 m2 , P = .45) and no significant increase in systolic blood pressure (z-scores 0.99 vs 0.85, P = .92). No side effects secondary to treatment with fludrocortisone were reported. A significant proportion of renal transplant patients were on sodium supplementation and fludrocortisone reduced sodium supplementation without significant effects on renal function or blood pressure. Fludrocortisone appears to be safe and effective for tubulopathies in children post-transplantation.
journal_name
Pediatr Transplantjournal_title
Pediatric transplantationauthors
Ali SR,Shaheen I,Young D,Ramage I,Maxwell H,Hughes DA,Athavale D,Shaikh MGdoi
10.1111/petr.13134subject
Has Abstractpub_date
2018-03-01 00:00:00issue
2eissn
1397-3142issn
1399-3046journal_volume
22pub_type
杂志文章abstract::PBSCs have become the preferred source of autologous stem cells for supporting high-dose chemotherapy in childhood solid tumors. The aims of this retrospective study were to examine the optimal timing for administration of G-CSF after chemotherapy and to identify the patients from whom an optimal dose of PBSCs can be ...
journal_title:Pediatric transplantation
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pub_type: 杂志文章,评审
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journal_title:Pediatric transplantation
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doi:10.1111/j.1399-3046.2011.01501.x
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journal_title:Pediatric transplantation
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journal_title:Pediatric transplantation
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12822
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13962
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2010.01428.x
更新日期:2011-03-01 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-3046.2003.00014.x
更新日期:2003-02-01 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/j.1399-3046.2007.00812.x
更新日期:2008-03-01 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12944
更新日期:2017-09-01 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract::Autoimmune and allergic diseases cause morbidity and diminished quality of life in pediatric organ transplant recipients. We hypothesize that younger age at transplantation and immunosuppression regimen play a role in the development of immune-mediated disease following heart transplant. A single institution retrospec...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12205
更新日期:2014-03-01 00:00:00
abstract::ABO-ILT have re-emerged as an alternate option for select patients awaiting transplant. However, treatment protocols for children undergoing deceased donor ABO-ILT are not standardized. We implemented a novel IS protocol for children undergoing deceased donor ABO-ILT based on pretransplant IH titers. Children with hig...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13263
更新日期:2018-11-01 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章,评审
doi:10.1111/j.1399-3046.2011.01633.x
更新日期:2012-02-01 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12339
更新日期:2014-11-01 00:00:00
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1034/j.1399-3046.2001.00049.x
更新日期:2001-06-01 00:00:00
abstract::Children receiving HCT loose protective immunity to vaccines received pre-HCT. Therefore, revaccination post-HCT is of major importance. In Denmark, a vaccination schedule with fewer doses post-HCT has been used, including two doses for diphtheria, tetanus, polio, measles, mumps, and rubella, and one dose only for Hae...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13599
更新日期:2020-02-01 00:00:00
abstract::Although de novo DSA are associated with inferior graft survival, there are no effective strategies to prevent their formation. Underexposure to MPA (prodrug: MMF) also contributes to rejection rates early after transplantation, but the effect of this phenomenon on the formation of DSA long-term post-transplantation i...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.12637
更新日期:2016-02-01 00:00:00
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journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13384
更新日期:2019-05-01 00:00:00
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journal_title:Pediatric transplantation
pub_type:
doi:10.1111/petr.13538
更新日期:2019-09-01 00:00:00
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journal_title:Pediatric transplantation
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journal_title:Pediatric transplantation
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doi:10.1111/j.1399-3046.2009.01281.x
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abstract::Primary graft dysfunction following HTx is associated with significant morbidity and mortality. This study aimed to assess the incidence of, risk factors for, and outcomes of children requiring ECMO within 24 hours of HTx. This study utilized a linked PHIS/SRTR database of pediatric HTx recipients (2002-2016). Post-HT...
journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13414
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13154
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journal_title:Pediatric transplantation
pub_type: 杂志文章
doi:10.1111/petr.13314
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abstract::A major risk faced by bone-marrow and solid organ transplant patients is the development of post-transplant lymphoproliferative disease or post-transplant lymphoma (PTLD). In pediatric transplantation, PTLD onset is often associated with a rapid rise in Epstein-Barr virus (EBV) load in peripheral blood mononuclear cel...
journal_title:Pediatric transplantation
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doi:10.1034/j.1399-3046.2003.00090.x
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abstract::Improving a patient's quality-of-life (QOL) post-liver transplantation is of great importance. An aspect of improved QOL is the restoration of normal growth patterns in pediatric patients. To describe the post-transplantation growth patterns of 72 children included in the National Institute of Diabetes and Digestive a...
journal_title:Pediatric transplantation
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journal_title:Pediatric transplantation
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