title: Impact of Maintenance Steroids versus Rapid Steroid Withdrawal in African-American Kidney Transplant Recipients: Comparison of Two Urban Centers.
abstract: BACKGROUND
  Rapid steroid withdrawal (RSW) is used increasingly in kidney transplantation but long-term outcomes in African-American (AA) recipients are not well known. We compared 1 and 5 year transplant outcomes in a large cohort of AA patients who were maintained on continued steroid therapy (CST) to those who underwent RSW.
  
  
  METHODS
  Post-transplant courses of A as receiving kidney allografts from 2003-2011 at two urban transplant centers in Chicago were followed. Prior to outcome analysis, we used Inverse Probability of Treatment Weights (IPTW) to match the two groups on a set of baseline risk factors. Graft and patient survival, GFR at 1 and 5 years, incidence and type of rejection, incidence of post-transplant diabetes mellitus (PTDM), delayed graft function, CMV and BK viremia were compared.
  
  
  RESULTS
  There were 150 AA recipients in the CST analytic group and 157 in the RSW analytic group. Graft and patient survival was similar between the two groups. Rates of CMV viremia were higher in the RSW compared to the CST analytic group at 1 year. Biopsy-proven acute rejection and PTDM were similar between the RSW and CST groups.
  
  
  CONCLUSIONS
  In AA recipients, RSW has similar long-term outcomes to CST.
authors.affiliation: Department of Medicine, Division of Nephrology, University of Chicago Medicine, Chicago, IL, USA.
authors.forename: W James
authors.initials: WJ
authors.lastname: Chon
authors.affiliation: Department of Medicine, Division of Nephrology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Amishi
authors.initials: A
authors.lastname: Desai
authors.affiliation: School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA.
authors.forename: Coady
authors.initials: C
authors.lastname: Wing
authors.affiliation: Department of Medicine, Division of Nephrology, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA.
authors.forename: Divya
authors.initials: D
authors.lastname: Arwindekar
authors.affiliation: Department of Medicine, Division of Nephrology, University of Illinois Hospital & Health Sciences System, Chicago, IL, USA; Department of Medicine, Division of Nephrology, Jesse Brown VA Medical Center, Chicago, IL, USA.
authors.forename: Ignatius Y S
authors.initials: IY
authors.lastname: Tang
authors.affiliation: Department of Medicine, Division of Nephrology, University of Chicago Medicine, Chicago, IL, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Josephson
authors.affiliation: Department of Medicine, Division of Nephrology, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Akkina
keywords: African-Americans; Kidney Transplant; Steroid Maintenance