title: The effect of low-dose corticosteroids on short- and long-term renal outcome in patients with cholesterol crystal embolism.
abstract: BACKGROUND
  The effect of corticosteroids on renal cholesterol crystal embolism (CCE) remains uncertain. The aim of the present study was to elucidate the effect of steroid therapy on short- and long-term renal outcome in CCE patients.
  
  
  METHODS
  Fifty-one patients diagnosed with renal CCE were included in this retrospective study. The patients were divided into two groups according to whether or not they had received steroid therapy (steroid therapy (+), n = 32; (-), n = 19). Corticosteroids were administered at an initial dose of 10-20 mg/day after CCE diagnosis. The values of the estimated glomerular filtration rate (eGFR) in the two groups were examined at CCE diagnosis, 4 weeks after diagnosis and the last follow-up. Additionally, the % change in eGFR at 4 weeks after diagnosis and % change per year in eGFR at the last follow-up were calculated for each patient.
  
  
  RESULTS
  The median values of eGFR at diagnosis in patients with and without steroid therapy were 16.4 and 17.9 mL/min/1.73 m(2), respectively. The median % change in eGFR between diagnosis and 4 weeks after diagnosis was 24% in patients with steroid therapy and 5% in those without, and this difference was statistically significant. On the other hand, there was no significant difference between the two groups in the % change in eGFR per year between diagnosis and the last follow-up.
  
  
  CONCLUSIONS
  During the short period after CCE diagnosis, steroid therapy showed a good renal outcome in CCE patients. However, this treatment did not have a favorable effect on long-term renal outcome.
authors.affiliation: Division of Nephrology and Clinical Research Institute, Department of Internal Medicine, National Kyushu Medical Center Hospital, Fukuoka, Japan. mnaka@kyumed.jp
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakayama
authors.forename: Kensuke
authors.initials: K
authors.lastname: Izumaru
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nagata
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ikeda
authors.forename: Kanako
authors.initials: K
authors.lastname: Nishida
authors.forename: Eri
authors.initials: E
authors.lastname: Hasegawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ohta
authors.forename: Takuya
authors.initials: T
authors.lastname: Tsuchihashi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Urabe
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D017700:Embolism, Cholesterol / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000209:etiology*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones