Steroid withdrawal in renal transplant patients: the Irish experience

Ir J Med Sci. 2011 Jun;180(2):429-33. doi: 10.1007/s11845-010-0626-8. Epub 2010 Oct 29.

Abstract

Background: Steroid therapy is associated with significant morbidity in renal transplant recipients. However, there is concern that steroid withdrawal will adversely affect outcome.

Methods: We report on 241 renal transplant recipients on different doses of corticosteroids at 3 months (zero, ≤ 5 mg/day, > 5 mg/day). Parameters analysed included blood pressure, lipid profile, weight change, new onset diabetes after transplantation (NODAT), allograft survival and acute rejection.

Results: Elimination of corticosteroids had no impact on allograft survival at 1 year. There were no cases of NODAT in the steroid withdrawal group compared with over 7% in each of the steroid groups. There were no significant improvements in weight gain, blood pressure control or total cholesterol with withdrawal of steroids before 3 months.

Conclusions: In renal transplant patients treated with tacrolimus and mycophenolate, early withdrawal of steroids does not appear to adversely affect allograft outcome at 1 year. It may result in less NODAT.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Adult
  • Diabetes Mellitus / etiology
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Graft Survival*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Ireland
  • Kidney Transplantation / immunology*
  • Male
  • Middle Aged
  • Mycophenolic Acid / analogs & derivatives
  • Mycophenolic Acid / therapeutic use
  • Retrospective Studies
  • Tacrolimus / therapeutic use
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Mycophenolic Acid
  • Tacrolimus