title: Early steroid withdrawal in a renal transplant cohort treated with tacrolimus, mycophenolate mofetil and basiliximab.
abstract: BACKGROUND
  Acute rejection and graft function have not been completely clarified in early-steroid-withdrawal (ESW) patients. The objective of this study was to compare the effect of early steroid withdrawal on GFR, graft survival/rejection in recipients in a cohort treated with tacrolimus/mycophenolate mofetil compared to a control cohort.
  
  
  METHODS
  Retrospective cohort, in 60 low immunological risk recipients between December 2005 and July 2010. Study cohort (ESW-C N=32), steroid withdrawal was carried out after 5 days, while they were receiving tacrolimus/mycophenolate mofetil. The control cohort (C-C, N=28) received prednisone/tacrolimus/mycophenolate mofetil. Clinical, biochemical and histological variables were assessed at baseline and after 3, 6, and 12 months of follow-up. Kaplan-Meier and the Cox proportional hazards model were used to assess survival. Comparisons between cohorts were carried out by the Student's t and c2 tests.
  
  
  RESULTS
  At follow-up, C-C displayed significantly higher systolic (125 ± 10 vs. 114 ± 8) and diastolic (81 ± 8 vs. 72 ± 7) blood pressure, serum glucose (96 ± 13 vs. 86 ± 10), triglycerides (177 ± 61 vs. 129 ± 34), total (183 ± 43 vs. 148 ± 34) and LDL-cholesterol (100 ± 22 vs. 87 ± 25). C-C had a higher proportion of antihypertensive (57 vs. 13%), and statins (27 vs. 9%) use. eGFR was better in ESW-C than in C-C (85.4 ± 20.6 vs. 70.6 ± 17.0, p=.004). AR frequency was lower in ESW-C.
  
  
  CONCLUSIONS
  Graft survival, GFR, AR rate and metabolic profile were better in the ESW-C than in C-C.
authors.forename: Jorge
authors.initials: J
authors.lastname: Andrade-Sierra
authors.forename: Enrique
authors.initials: E
authors.lastname: Rojas-Campos
authors.forename: Ernesto
authors.initials: E
authors.lastname: Cardona-Muñoz
authors.forename: Luis A
authors.initials: LA
authors.lastname: Evangelista-Carrillo
authors.forename: Abel
authors.initials: A
authors.lastname: Puentes-Camacho
authors.forename: Orlando
authors.initials: O
authors.lastname: Lugo-López
authors.forename: Benjamín
authors.initials: B
authors.lastname: Gómez
authors.forename: Carlos
authors.initials: C
authors.lastname: Valdespino
authors.forename: Ignacio
authors.initials: I
authors.lastname: Cerrillos
authors.forename: Miguel
authors.initials: M
authors.lastname: Medina-Pérez
authors.forename: Basilio
authors.initials: B
authors.lastname: Jalomo
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Nieves
authors.forename: Mario
authors.initials: M
authors.lastname: Sandoval
authors.forename: Francisco
authors.initials: F
authors.lastname: Ramos-Solano
authors.forename: Francisco
authors.initials: F
authors.lastname: Monteón-Ramos
authors.forename: Alfonso M
authors.initials: AM
authors.lastname: Cueto-Manzano
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000077552:Basiliximab; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006084:Graft Rejection / Q000453:epidemiology; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use*; D013997:Time Factors; D028761:Withholding Treatment
chemical_list: D000911:Antibodies, Monoclonal; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab; D009173:Mycophenolic Acid; D011241:Prednisone; D016559:Tacrolimus