RT info:eu-repo/semantics/article
T1 Effect of long-term steroid withdrawal in renal transplant recipients: a retrospective cohort study
A1 Gonzalez-Molina Alcaide, Miguel
A1 Gentil Govantes, Miguel Angel
A1 Burgos Rodríguez, Dolores
A1 Cabello Díaz, Mercedes
A1 Cobelo Casas, Carmen
A1 Bustamante Bustamante, Jesús
A1 Errasti Goenaga, Pedro
A1 Franco Esteve, Antonio
A1 Hernández Marrero, Domingo
K1 Riñones - Trasplante
K1 Esteroides
K1 3205.06 Nefrología
AB Background. Steroids are largely effective for the immunosuppressive treatment in renal transplant patients, but cause severe side effects. Whether steroid withdrawal confers long-term beneficial effects remains unclear. Methods. Data on 4481 cadaveric kidney transplant recipients were collected to estimate the impact of steroid withdrawal on kidney function and graft and patient survival using multivariate Cox regression models. Results. A total of 923 patients (20.6%) had steroid treatment withdrawn. This was more common in recipients from younger donors and in older recipients, and in recipients with a first transplant, those who had pre-transplant or de novo diabetes mellitus and those with fewer episodes of acute rejection (AR) (22.4% vs. 29.2%, P < 0.001). Cox multivariate analysis stratifying by propensity scores showed that longterm steroid therapy was associated with a 70% increase in the risk of patient death. The repeated measures linear model showed that, although the abbreviated Modification of Diet in Renal Disease (aMDRD) values changed over time (P = 0.002), this was independent of steroid withdrawal (P = 0.08). In addition, of the 772 (17.2%) recipients who developed de novo diabetes mellitus, 204 (26.4%) ceased antidiabetic therapy, with more of these among those who ceased steroids (23% vs. 33.3%, P = 0.003). Blood pressure, cholesterol and triglyceride values were all significantly lower in the patients who ceased steroids. Conclusions. Steroid withdrawal in selected patients had no negative effect over time on renal function and graft survival, and it was associated with reduced mortality.
PB Oxford University Press
SN 2048-8505
YR 2010
FD 2010
LK https://uvadoc.uva.es/handle/10324/50947
UL https://uvadoc.uva.es/handle/10324/50947
LA eng
NO NDT Plus, 2010, vol. 3, supl. 2, p. 32–36
NO Producción Científica
DS UVaDOC
RD 25-abr-2024