High- versus low-dose methylprednisolone for acute rejection episodes in renal transplantation.
A double-blind, randomized trial was conducted to compare the efficacy and safety of two doses of methylprednisolone (MP) in reversing acute rejection episodes in renal allograft recipients. 18 subjects were randomized to receive either 250 mg (group 1) or 1,000 mg (group 2) MP daily for 4 days. The two groups were similar with regard to HLA matching, number of cadaveric grafts, number of second transplants, and transfusion history. 6 of 10 patients in group 1 and 4 of 8 in group 2 responded to treatment with MP, i.e., serum creatinine returned to baseline. 1-year follow-up has demonstrated a similar graft survival, 70% in group 1 and 50% in group 2. There were no significant differences in mortality, infectious complications, blood glucose, and blood pressure between the two groups. We conclude that (1) 250 mg MP is as effective as 1,000 mg in reversing acute rejection in renal allografts; (2) 1,000 mg MP does not result in a greater incidence of adverse effects, and (3) 250 mg MP does not adversely affect 1-year graft survival.
D000208:Acute Disease; D000328:Adult; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D006084:Graft Rejection / Q000187:drug effects*; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000494:pharmacology; D008875:Middle Aged; D011897:Random Allocation
D008775:Methylprednisolone