[Skip to Content]
[Skip to Content Landing]
July 11, 1980

Stability of Renal Transplant Function With Alternate-Day Corticosteroid Therapy

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.

JAMA. 1980;244(2):151-156. doi:10.1001/jama.1980.03310020027021

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)