SynthesisPloS one2016
Steroid Avoidance or Withdrawal Regimens in Paediatric Kidney Transplantation: A Meta-Analysis of Randomised Controlled Trials.
Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Clinical practice recommendations for growth hormone treatment in children with chronic kidney disease.Nature reviews. Nephrology · 2019Guideline
- Steering Transplant Immunosuppression by Measuring Virus-Specific T Cell Levels: The Randomized, Controlled IVIST Trial.Journal of the American Society of Nephrology : JASN · 2021Trial
- Twenty-Year Kidney Transplant Outcomes With Prednisone-Free Maintenance Immunosuppression: A Matched Control Analysis.Clinical transplantation · 2025Article
- Understanding Pediatric Kidney Transplant Rejection: Its Pathophysiology, Biomarkers, and Management Strategies.Current medicinal chemistry · 2025Review
- Growth hormone therapy in pediatric kidney transplantation-the long-term clinical benefits beyond improvement of growth after withdrawal of pre-transplant therapy.Pediatric nephrology (Berlin, Germany) · 2022Article
- Post-transplant lymphoproliferative disease after pediatric kidney transplant.Frontiers in pediatrics · 2022Review
- Acute rejection and growth outcomes in paediatric kidney allograft recipients treated with a corticosteroid minimisation immunosuppressive protocol.Pediatric nephrology (Berlin, Germany) · 2021Article
- Novel ways to monitor immunosuppression in pediatric kidney transplant recipients-underlying concepts and emerging data.Molecular and cellular pediatrics · 2021Review
- Does steroid-free immunosuppression improve the outcome in kidney transplant recipients compared to conventional protocols?World journal of transplantation · 2021Review
- CKD-MBD post kidney transplantation.Pediatric nephrology (Berlin, Germany) · 2021Article
- State-of-the-art immunosuppression protocols for pediatric renal transplant recipients.Pediatric nephrology (Berlin, Germany) · 2019Review
- Recent advances in kidney transplantation: a viewpoint from the Descartes advisory board.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2018Review
- Combination therapy of rituximab and mycophenolate mofetil in childhood lupus nephritis.Pediatric nephrology (Berlin, Germany) · 2018Article
- Graft survival of pediatric kidney transplant recipients selected for de novo steroid avoidance-a propensity score-matched study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2017Article
- Brazilian guidelines for chronic kidney disease-mineral and bone metabolism disorders in children and adolescents.Jornal brasileiro de nefrologiaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe combined the outcomes of all randomised controlled trials to investigate the safety and efficacy of steroid avoidance or withdrawal (SAW) regimens in paediatric kidney transplantation compared with steroid-based (SB) regimens.
methodsA systematic literature search of PubMed, Embase, Cochrane Library, the trials registry and BIOSIS previews was performed. A change in the height standardised Z-score from baseline (ΔHSDS) and acute rejection were the primary endpoints.
resultsEight reports from 5 randomised controlled trials were included, with a total of 528 patients. Sufficient evidence of a significant increase in the ΔHSDS was observed in the SAW group (mean difference (MD) = 0.38, 95% confidence interval (CI) 0.07-0.68, P = 0.01), particularly within the first year post-withdrawal (MD = 0.22, 95% CI 0.10-0.35, P = 0.0003) and in the prepubertal recipients (MD = 0.60, 95% CI 0.21-0.98, P = 0.002). There was no significant difference in the risk of acute rejection between the groups (relative risk = 1.04, 95% CI 0.80-1.36, P = 0.77).
conclusionsThe SAW regimen is justified in select paediatric renal allograft recipients because it provides significant benefits in post-transplant growth within the first year post-withdrawal with minimal effects on the risk of acute rejection, graft function, and graft and patient survival within 3 years post-withdrawal. These select paediatric recipients should have the following characteristics: prepubertal; Caucasian; with primary disease not related to immunological factors; de novo kidney transplant recipient; with low panel reactive antibody.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.