ArticleBMC medicine2017
Steroid withdrawal after renal transplantation: a retrospective cohort study.
Article in BMC medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Rapid Corticosteroid Withdrawal After Cardiac Transplantation Improves Outcomes.Clinical transplantation · 2025Article
- Multicenter, Real-World Clinical Evaluation of Alemtuzumab and Anti-Thymocyte Globulin for Severe Acute T Cell-Mediated Kidney Transplant Rejection.Clinical transplantation · 2024Article
- Article
- New-Onset Diabetes Mellitus after Kidney Transplantation.Journal of clinical medicine · 2024Review
- International consensus on post-transplantation diabetes mellitus.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2024Article
- Post-Transplant Bone Disease in Kidney Transplant Recipients: Diagnosis and Management.International journal of molecular sciences · 2024Review
- Sex differences in the survival benefit of kidney transplantation: a retrospective cohort study using target trial emulation.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- Development and Validation of a New Score to Assess the Risk of Posttransplantation Diabetes Mellitus in Kidney Transplant Recipients.Transplantation direct · 2023Article
- Changes in glucose metabolism among recipients with diabetes 1 year after kidney transplant: a multicenter 1-year prospective study.Frontiers in endocrinology · 2023Article
- Safety and metabolic advantages of steroid withdrawal after 6 months posttransplant in de novo kidney transplantation: A 1-year prospective cohort study.Immunity, inflammation and disease · 2022Article
- Protocol Biopsies on de novo Renal-Transplants at 3 Months after Surgery: Impact on 5-Year Transplant Survival.Journal of clinical medicine · 2021Article
- Individual Lymphocyte Sensitivity to Steroids as a Reliable Biomarker for Clinical Outcome after Steroid Withdrawal in Japanese Renal Transplantation.Journal of clinical medicine · 2021Article
- Sex Differences in Kidney Transplantation: Austria and the United States, 1978-2018.Frontiers in medicine · 2021Article
- Erectile Dysfunction after Kidney Transplantation.Journal of clinical medicine · 2020Review
- Peripheral blood lymphocyte subsets change after steroid withdrawal in renal allograft recipients: a prospective study.Scientific reports · 2019Article
- Characterizing the pharmacokinetics and pharmacodynamics of immunosuppressant medicines and patient outcomes in elderly renal transplant patients.Translational andrology and urology · 2019Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundImmunosuppressive regimens in renal transplantation frequently contain corticosteroids, but many centers withdraw steroids as a consequence of unwanted side effects of steroids. The optimal timing to withdraw steroids after transplantation, however, remains unclear. The aim of this study was to determine an optimal time point following kidney transplantation that is associated with reduced mortality without jeopardizing the allograft to allow safe discontinuation of steroids.
methodsWe conducted a retrospective cohort study and computed a concatenated landmark-stratified Cox supermodel to estimate hazard ratios and 95% confidence intervals for mortality and graft loss using dynamic propensity score matching to adjust for confounding by indication.
resultsA total of 6070 first kidney transplant recipients in the Austrian Dialysis and Transplant Registry who were transplanted between 1990 and 2012 were evaluated and classified according to steroid treatment status throughout follow-up after kidney transplantation; 2142 patients were withdrawn from steroids during the study period. Overall, 1131 patients lost their graft and 821 patients in the study cohort died. Steroid withdrawal within 18 months after transplantation was associated with an increased rate of graft loss compared to steroid maintenance during that time (6 months after transplantation: HR = 1.8; 95% CI, 1.3 to 2.6; 18 months after transplantation: HR = 1.3; 95% CI, 1.1 to 1.6; 24 months after transplantation: HR = 1.2; 95% CI, 0.9 to 1.5), while mortality was not different between groups.
conclusionsOur findings suggest that steroid withdrawal after anti-IL-2 induction in the first 18 months after transplantation is associated with an increased risk of allograft loss.
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