title: Early Steroid Withdrawal in Recipients of a Kidney Transplant From a Living Donor: Experience of a Single Mexican Center.
abstract: BACKGROUND
  Early steroid withdrawal (ESW) can improve lipid and hemodynamic profiles without severe acute rejection (AR) events in renal transplant patients. Our objective was to evaluate the effects of ESW on the frequency and severity of AR.
  
  
  METHODS
  A randomized, open-label, controlled clinical trial was performed on renal transplant recipients with a follow-up of 12 months. In the ESW group, patients were selected for corticosteroid treatment withdrawal on the fifth day post transplantation. In the Control group, patients continued with steroid treatment. All patients were over 18 years of age with panel reactive antibody (PRA) class I and II HLA <20%.
  
  
  RESULTS
  In total, 71 patients, 37 in the ESW group (52.1%) and 34 in the Control group (47.9%), had comparable AR incidences at the end of the follow-up (16% vs 15%) (NS) (RR = 1.20, 95% CI = 0.32-3.33). Although renal graft survival was similar between the ESW and Control groups (87% vs 94%), renal function was superior in the ESW group (85 vs 75 mL/min). Additionally, hypertension was less frequent in the ESW group (3% vs 35%), requiring the use of fewer antihypertensives (8% vs 50%).
  
  
  CONCLUSIONS
  ESW was also associated with better blood pressure control and similar AR risk. The ESW group exhibited stable renal function.
authors.affiliation: Medical Research Unit in Renal Diseases, Guadalajara, Jalisco, Mexico; Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico; Department of Physiology, Centro Universitario de Ciencias de la Salud, University of Guadalajara, Guadalajara, Jalisco, Mexico. Electronic address: Jorg_Andrade@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Andrade-Sierra
authors.affiliation: Medical Research Unit in Renal Diseases, Guadalajara, Jalisco, Mexico.
authors.forename: E
authors.initials: E
authors.lastname: Rojas-Campos
authors.affiliation: Department of Physiology, Centro Universitario de Ciencias de la Salud, University of Guadalajara, Guadalajara, Jalisco, Mexico.
authors.forename: E
authors.initials: E
authors.lastname: Cardona-Muñoz
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: L A
authors.initials: LA
authors.lastname: Evangelista-Carrillo
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: B
authors.initials: B
authors.lastname: Gómez-Navarro
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: E
authors.initials: E
authors.lastname: González-Espinoza
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: O
authors.initials: O
authors.lastname: Lugo-Lopez
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: J I
authors.initials: JI
authors.lastname: Cerrillos-Gutiérrez
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: M
authors.initials: M
authors.lastname: Medina-Pérez
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: B
authors.initials: B
authors.lastname: Jalomo-Martínez
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: J J
authors.initials: JJ
authors.lastname: Nieves-Hernández
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: M
authors.initials: M
authors.lastname: Sandoval
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: J R
authors.initials: JR
authors.lastname: Abundis-Jiménez
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: J N
authors.initials: JN
authors.lastname: Ramírez-Robles
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: M A
authors.initials: MA
authors.lastname: Villanueva-Pérez
authors.affiliation: Department of Nephrology and Organ Transplant Unit of the Specialties Hospital, Western National Medical Center, Mexican Social Security Institute (IMSS), Guadalajara, Jalisco, Mexico.
authors.forename: F
authors.initials: F
authors.lastname: Monteón-Ramos
authors.affiliation: Medical Research Unit in Renal Diseases, Guadalajara, Jalisco, Mexico.
authors.forename: A M
authors.initials: AM
authors.lastname: Cueto-Manzano
mesh_terms: D000328:Adult; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008800:Mexico; D008875:Middle Aged; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D013256:Steroids