PMID- 26915841
OWN - NLM
STAT- MEDLINE
DCOM- 20161021
LR  - 20161230
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 48
IP  - 1
DP  - 2016 Jan-Feb
TI  - Early Steroid Withdrawal in Recipients of a Kidney Transplant From a Living
      Donor: Experience of a Single Mexican Center.
PG  - 42-9
LID - 10.1016/j.transproceed.2015.12.013 [doi]
LID - S0041-1345(15)01190-2 [pii]
AB  - BACKGROUND: Early steroid withdrawal (ESW) can improve lipid and hemodynamic
      profiles without severe acute rejection (AR) events in renal transplant patients.
      Our objective was to evaluate the effects of ESW on the frequency and severity of
      AR. METHODS: A randomized, open-label, controlled clinical trial was performed on
      renal transplant recipients with a follow-up of 12 months. In the ESW group,
      patients were selected for corticosteroid treatment withdrawal on the fifth day
      post transplantation. In the Control group, patients continued with steroid
      treatment. All patients were over 18 years of age with panel reactive antibody
      (PRA) class I and II HLA <20%. RESULTS: In total, 71 patients, 37 in the ESW
      group (52.1%) and 34 in the Control group (47.9%), had comparable AR incidences
      at the end of the follow-up (16% vs 15%) (NS) (RR = 1.20, 95% CI = 0.32-3.33).
      Although renal graft survival was similar between the ESW and Control groups (87%
      vs 94%), renal function was superior in the ESW group (85 vs 75 mL/min).
      Additionally, hypertension was less frequent in the ESW group (3% vs 35%),
      requiring the use of fewer antihypertensives (8% vs 50%). CONCLUSIONS: ESW was
      also associated with better blood pressure control and similar AR risk. The ESW
      group exhibited stable renal function.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Andrade-Sierra, J
AU  - Andrade-Sierra J
AD  - Medical Research Unit in Renal Diseases, Guadalajara, Jalisco, Mexico; Department
      of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western
      National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara,
      Jalisco, Mexico; Department of Physiology, Centro Universitario de Ciencias de la
      Salud, University of Guadalajara, Guadalajara, Jalisco, Mexico. Electronic
      address: Jorg_Andrade@hotmail.com.
FAU - Rojas-Campos, E
AU  - Rojas-Campos E
AD  - Medical Research Unit in Renal Diseases, Guadalajara, Jalisco, Mexico.
FAU - Cardona-Munoz, E
AU  - Cardona-Munoz E
AD  - Department of Physiology, Centro Universitario de Ciencias de la Salud,
      University of Guadalajara, Guadalajara, Jalisco, Mexico.
FAU - Evangelista-Carrillo, L A
AU  - Evangelista-Carrillo LA
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Gomez-Navarro, B
AU  - Gomez-Navarro B
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Gonzalez-Espinoza, E
AU  - Gonzalez-Espinoza E
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Lugo-Lopez, O
AU  - Lugo-Lopez O
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Cerrillos-Gutierrez, J I
AU  - Cerrillos-Gutierrez JI
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Medina-Perez, M
AU  - Medina-Perez M
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Jalomo-Martinez, B
AU  - Jalomo-Martinez B
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Nieves-Hernandez, J J
AU  - Nieves-Hernandez JJ
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Sandoval, M
AU  - Sandoval M
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Abundis-Jimenez, J R
AU  - Abundis-Jimenez JR
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Ramirez-Robles, J N
AU  - Ramirez-Robles JN
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Villanueva-Perez, M A
AU  - Villanueva-Perez MA
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Monteon-Ramos, F
AU  - Monteon-Ramos F
AD  - Department of Nephrology and Organ Transplant Unit of the Specialties Hospital,
      Western National Medical Center, Mexican Social Security Institute (IMSS),
      Guadalajara, Jalisco, Mexico.
FAU - Cueto-Manzano, A M
AU  - Cueto-Manzano AM
AD  - Medical Research Unit in Renal Diseases, Guadalajara, Jalisco, Mexico.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Steroids)
SB  - IM
MH  - Adult
MH  - Female
MH  - Graft Rejection/immunology/*prevention & control
MH  - Graft Survival/*drug effects
MH  - Humans
MH  - Kidney Transplantation/*adverse effects/methods
MH  - Living Donors
MH  - Male
MH  - Mexico
MH  - Middle Aged
MH  - Steroids/*administration & dosage/adverse effects
MH  - Treatment Outcome
MH  - *Withholding Treatment
EDAT- 2016/02/27 06:00
MHDA- 2016/10/22 06:00
CRDT- 2016/02/27 06:00
PHST- 2015/09/10 00:00 [received]
PHST- 2015/11/25 00:00 [revised]
PHST- 2015/12/10 00:00 [accepted]
PHST- 2016/02/27 06:00 [entrez]
PHST- 2016/02/27 06:00 [pubmed]
PHST- 2016/10/22 06:00 [medline]
AID - S0041-1345(15)01190-2 [pii]
AID - 10.1016/j.transproceed.2015.12.013 [doi]
PST - ppublish
SO  - Transplant Proc. 2016 Jan-Feb;48(1):42-9. doi:
      10.1016/j.transproceed.2015.12.013.