Early steroid withdrawal does not increase risk for recurrent focal segmental glomerulosclerosis.
Experience with early corticosteroid withdrawal (CSWD) in renal transplant recipients with focal segmental glomerulosclerosis (FSGS) has not been previously reported. Since corticosteroids are used to treat primary FSGS, concern exists as to whether early CSWD regimens will be associated with an increased risk of FSGS recurrence posttransplant. The purpose of the present study was to evaluate the results of early CSWD in FSGS recipients and compare these results to a historic control group of FSGS patients who underwent renal transplantation under corticosteroid-based immunosuppression.


METHODS
Forty-three patients with FSGS underwent renal transplantation with early CSWD. Results in these patients were compared to FSGS patients that underwent renal transplantation with chronic corticosteroid therapy. All rejection episodes were biopsy proven with grading by Banff criteria. Statistical analyses included Student's t test and chi square tests.


RESULTS
Results in 43 patients with a median follow-up of 569 days were analyzed and compared to control patients. There was no significant difference in recurrent FSGS, time to recurrence, or graft loss.


CONCLUSIONS
CSWD does not increase risk for recurrence of FSGS. These observations indicate that ECSW can be achieved in FSGS patients, thereby affording them the benefits of steroid elimination.
Boardman
R
R
University of Cincinnati, Cincinnati, Ohio 45249, USA.
Trofe
J
J
Alloway
R
R
Rogers
C
C
Roy-Chaudhury
P
P
Cardi
M
M
Safdar
S
S
Groene
B
B
Buell
J
J
Hanaway
M
M
Thomas
M
M
Alexander
W
W
Munda
R
R
Woodle
E S
ES
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D003404:Creatinine / Q000097:blood; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D005923:Glomerulosclerosis, Focal Segmental / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D016030:Kidney Transplantation / Q000473:pathology*; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure
D000305:Adrenal Cortex Hormones; D003404:Creatinine