Withdrawal of prednisone from a triple combination of immunosuppressive agents after kidney transplantation
BACKGROUND: Triple-drug immunosuppression may not be necessary in a majority of stabilized patients over 1 year after kidney transplantation. In contrary steroid withdrawal may be beneficial for the patient by elimination of side-effects. The primary aim of this study was assessment of the risk of rejection after the prednisone withdrawal.
METHODS AND RESULTS: 88 patients 1 year after the first renal transplantation with stable graft function and serum creatinine < 160 mumol/l treated with cyclosporine-A, azathioprine and prednisone were randomized into group A (n = 46) with a prednisone withdrawal and group B (n = 42) on triple-drug therapy without change. At the time of randomization, fine-needle biopsy was carried out in all of the patients. In group A, the dose of prednisone was gradually reduced to zero in the course of six months and the patients were followed up for the next 12 months. In the group B, patients on triple-drug therapy were followed for the corresponding period of time. 3 patients (6.6%) in group A, and 2 (4.8%) in group B experienced rejection (NS). Mean values of serum creatinine were in the course of follow-up in both groups without any statistical difference. Suspect immunological activity or proved immunological activity in aspiration biopsy was present in 4 patients in each group, but one of them rejected the graft. In comparison with group B, a significant decrease of cholesterol and leukocytes was observed in group A. Prednisone withdrawal had no influence on hypertension and triglyceride.
CONCLUSIONS: Gradual withdrawal of steroids is not associated with higher risks of rejection and has a beneficial effect on cholesterol levels. Aspiration biopsy was of no use for the prediction of rejection.
| Medienart: |
Artikel |
|---|
| Erscheinungsjahr: |
2000 |
|---|---|
| Erschienen: |
2000 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:139 |
|---|---|
| Enthalten in: |
Casopis lekaru ceskych - 139(2000), 4 vom: 01. März, Seite 115-9 |
| Sprache: |
Tschechisch |
|---|
| Weiterer Titel: |
Vysazení prednisonu z trojkombinace imunosupresiv u nemocných po transplantaci ledviny |
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| Beteiligte Personen: |
Matl, I [VerfasserIn] |
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| Anmerkungen: |
Date Completed 27.06.2000 Date Revised 21.11.2013 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
|
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| PPN (Katalog-ID): |
NLM107638975 |
|---|
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| 100 | 1 | |a Matl, I |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Withdrawal of prednisone from a triple combination of immunosuppressive agents after kidney transplantation |
| 246 | 3 | 3 | |a Vysazení prednisonu z trojkombinace imunosupresiv u nemocných po transplantaci ledviny |
| 264 | 1 | |c 2000 | |
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| 500 | |a Date Completed 27.06.2000 | ||
| 500 | |a Date Revised 21.11.2013 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Triple-drug immunosuppression may not be necessary in a majority of stabilized patients over 1 year after kidney transplantation. In contrary steroid withdrawal may be beneficial for the patient by elimination of side-effects. The primary aim of this study was assessment of the risk of rejection after the prednisone withdrawal | ||
| 520 | |a METHODS AND RESULTS: 88 patients 1 year after the first renal transplantation with stable graft function and serum creatinine < 160 mumol/l treated with cyclosporine-A, azathioprine and prednisone were randomized into group A (n = 46) with a prednisone withdrawal and group B (n = 42) on triple-drug therapy without change. At the time of randomization, fine-needle biopsy was carried out in all of the patients. In group A, the dose of prednisone was gradually reduced to zero in the course of six months and the patients were followed up for the next 12 months. In the group B, patients on triple-drug therapy were followed for the corresponding period of time. 3 patients (6.6%) in group A, and 2 (4.8%) in group B experienced rejection (NS). Mean values of serum creatinine were in the course of follow-up in both groups without any statistical difference. Suspect immunological activity or proved immunological activity in aspiration biopsy was present in 4 patients in each group, but one of them rejected the graft. In comparison with group B, a significant decrease of cholesterol and leukocytes was observed in group A. Prednisone withdrawal had no influence on hypertension and triglyceride | ||
| 520 | |a CONCLUSIONS: Gradual withdrawal of steroids is not associated with higher risks of rejection and has a beneficial effect on cholesterol levels. Aspiration biopsy was of no use for the prediction of rejection | ||
| 650 | 4 | |a Clinical Trial | |
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Glucocorticoids |2 NLM | |
| 650 | 7 | |a Immunosuppressive Agents |2 NLM | |
| 650 | 7 | |a Cyclosporine |2 NLM | |
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| 700 | 1 | |a Lodererová, A |e verfasserin |4 aut | |
| 700 | 1 | |a Símová, M |e verfasserin |4 aut | |
| 700 | 1 | |a Teplan, V |e verfasserin |4 aut | |
| 700 | 1 | |a Lánská, V |e verfasserin |4 aut | |
| 700 | 1 | |a Vítko, S |e verfasserin |4 aut | |
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