title: Stress dose steroids in renal transplant patients undergoing lymphocele surgery.
abstract: The requirement for perioperative stress dose steroids (SDS) in patients on long-term steroid therapy is controversial, but SDS are given during perioperative care. Studies focusing on surrogate outcomes like cortisol levels indicate a possible requirement for SDS, but clinical results are sparse. We retrospectively compared outcomes of renal or pancreas/kidney transplant patients undergoing surgical lymphocele drainage who did (n=20) or did not (n=38) receive SDS. Patients had similar demographic characteristics (P=NS). No patient developed hypotension (SBP < 80 mmHg), mental status change, unexplained arthralgias, or ileus. Impaired wound healing occurred in one patient in each group (P=NS), and lymphocele recurrence occurred in 25% of the SDS group and 10.5% of the other group (P=.25). SBP decreased from baseline in both groups (P <.001) but did not differ between groups, and maximum blood glucose was higher in the SDS group (P=.04). No difference was observed in other measured parameters. These data indicate that SDS increased the risk of hyperglycemia and provided no apparent benefit. A prospective study is warranted to confirm these findings.
authors.affiliation: Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Livingston, NJ 07039-56720, USA. smathis@sbhcs.com
authors.forename: A S
authors.initials: AS
authors.lastname: Mathis
authors.forename: N K
authors.initials: NK
authors.lastname: Shah
authors.forename: S
authors.initials: S
authors.lastname: Mulgaonkar
mesh_terms: D000328:Adult; D001794:Blood Pressure; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000209:etiology* / Q000601:surgery; D016030:Kidney Transplantation / Q000502:physiology*; D008210:Lymphocele / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D013256:Steroids / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013256:Steroids; D011241:Prednisone