This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Richard V. Breitenfield, MD; Lee A. Hebert, MD; Jacob Lemann, Jr, MD; Walter F. Piering, MD; H. Myron Kauffman, MD; Derek Sampson, MD; John Kalbfleisch, MD; Joseph A. Beres, MD

JAMA. 1980;244(2):151-156.

Abstract
Fifty-three renal transplant recipients with good to excellent renal function, while receiving daily maintenance or near-maintenance doses of azathioprine and methylprednisolone, were gradually converted to alternate-day corticosteroid therapy. Stability of allograft glomerular filtration rate (GFR) in each patient was assessed by calculating the slope of a plot of the reciprocal of the serum creatinine concentration vs time. After conversion to alternate-day therapy, GFR was stable in 80% but deteriorated in 20% of patients. However, most of the patients who experienced deteriorating GFR during alternate-day therapy regained stable renal function when given the same total corticosteroid dose but on a daily basis. This suggests but does not prove that maintenance-level daily corticosteroid therapy is better than maintenance-level alternate-day therapy in stabilizing allograft function. We conclude that maintenance-level alternate-day corticosteroid therapy should be used cautiously until a long-term prospective study determines whether there is an increased risk of losing renal function with this schedule and whether this potential risk is offset by reduced corticosteroid toxicity.

(JAMA 244:151-156, 1980)

Author Affiliations
From the Departments of Medicine (Drs Breitenfield, Hebert, Lemann, Piering, and Beres), Surgery (Drs Kauffman and Sampson), and Biostatistics (Dr Kalbfleisch), Medical College of Wisconsin and Milwaukee County Medical Complex, Milwaukee. Dr Hebert is now with the Department of Medicine, Ohio State University College of Medicine, Columbus.

Footnotes
Read in part before the tenth annual meeting of the American Society of Nephrology, Washington, DC, Nov 20, 1977.

Reprint requests to Department of Medicine, Ohio State University College of Medicine, 410 W Tenth Ave, Columbus, OH 43210 (Dr Hebert).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Living Donor in Kidney Transplantation
BAY and HEBERT
ANN INTERN MED 1987;106:719-727.
ABSTRACT