title: Low-dose steroid maintenance for renal transplant recipients.
abstract: OBJECTIVE
  We investigated the efficacy and safety of an immunosuppressive regimen consisting of tacrolimus or cyclosporine, with basiliximab, mycophenolate mofetil or mizoribine, and low-dose steroids (prednisone <2.5 mg/d) for kidney transplant recipients.
  
  
  METHODS
  We conducted a prospective study of 51 recipients with stable graft function who underwent kidney transplantation between August 2005 and December 2009. The oral dose of prednisone was gradually tapered to <2.5 mg/d within 2 months after transplantation. We assessed, patient and graft survivals, incidence of rejection episodes, transplant function and steroid side effects.
  
  
  RESULTS
  Death-censored graft survival was 100%, and the mean serum creatinine levels remained stable at 1.31, 1.37, and 1.48 mg/dL at 1, 2, and 3 years, respectively, after transplantation. There were seven biopsy-proven rejection episodes (mean = 110 days; range = 14-436) after prednisone was decreased. The cumulative incidence of biopsy-proven rejection was 11.2%, 17.0%, and 17.0%, respectively. In addition, the mean blood pressure was stable (127/78 mm Hg, 125/77 mm Hg, and 125/76 mmHg, respectively), whereas the mean serum cholesterol and triglyceride levels remained within normal limits. Only 3 patients (7%) displayed new onset diabetes after transplantation.
  
  
  CONCLUSIONS
  Low-dose steroid maintenance therapy is safe with beneficial effects on cardiovascular risk factors.
authors.affiliation: Renal Transplantation Center, Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan. hidefumi69@hotmail.com
authors.forename: H
authors.initials: H
authors.lastname: Kishikawa
authors.forename: K
authors.initials: K
authors.lastname: Nishimura
authors.forename: T
authors.initials: T
authors.lastname: Soda
authors.forename: K
authors.initials: K
authors.lastname: Yamanaka
authors.forename: T
authors.initials: T
authors.lastname: Hirai
authors.forename: M
authors.initials: M
authors.lastname: Kyo
authors.forename: M
authors.initials: M
authors.lastname: Takeda
authors.forename: M
authors.initials: M
authors.lastname: Fujisawa
authors.forename: Y
authors.initials: Y
authors.lastname: Kokado
authors.forename: Y
authors.initials: Y
authors.lastname: Ichikawa
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D000077552:Basiliximab; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D011241:Prednisone / Q000008:administration & dosage* / Q000009:adverse effects; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage; D012263:Ribonucleosides / Q000008:administration & dosage; D016559:Tacrolimus / Q000008:administration & dosage
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D012263:Ribonucleosides; C010052:mizoribine; D016572:Cyclosporine; D000077552:Basiliximab; D003404:Creatinine; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus