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Association between steroid dosage and death with a functioning graft after kidney transplantation.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2013 Aug; Vol. 13 (8), pp. 2096-105. Date of Electronic Publication: 2013 Jun 10. - Publication Year :
- 2013
-
Abstract
- Death with a functioning graft remains a major challenge following kidney transplantation. Steroid dosing may be a modifiable risk factor. Collaborative Transplant Study (CTS) data were analyzed to assess the relationship between long-term steroid dose and death with function during years 2-5 posttransplant in 41 953 adult recipients of a deceased-donor kidney transplant during 1995-2010. Steroid dose at year 1 correlated significantly with death with function overall, and with death due to cardiovascular disease or infection (all p < 0.001). In patients with optimal graft function (serum creatinine <130 µmol/L) and no anti-rejection treatment during (a) year 1 (b) years 1 and 2, these significant associations remained (all p < 0.001). The center-specific incidence of steroid withdrawal during year 2 showed a significant inverse association with death due to cardiovascular disease (p < 0.001) or infection (p < 0.001) overall, and within the subpopulation with good graft function and no rejection during year 1 (p = 0.002 and p < 0.001, respectively). Maintenance steroid dose shows a highly significant association with death with a functioning graft caused by cardiovascular disease or infection during years 2-5 after kidney transplantation, even in patients with good graft outcomes in whom steroid treatment would appear to be unnecessary.<br /> (© Copyright 2013 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Adolescent
Adult
Anti-Inflammatory Agents administration & dosage
Anti-Inflammatory Agents adverse effects
Cardiovascular Diseases etiology
Female
Graft Rejection etiology
Humans
Immunosuppressive Agents therapeutic use
Infections etiology
International Agencies
Kidney Failure, Chronic complications
Kidney Failure, Chronic mortality
Male
Middle Aged
Prednisone administration & dosage
Retrospective Studies
Survival Rate
Young Adult
Cardiovascular Diseases mortality
Graft Rejection mortality
Graft Survival drug effects
Infections mortality
Kidney Failure, Chronic therapy
Kidney Transplantation mortality
Prednisone adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 13
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 23750878
- Full Text :
- https://doi.org/10.1111/ajt.12313