Variable Effects of Steroid Withdrawal on Blood Pressure Reduction in Cyclosporine-Treated Renal Transplant Recipients

Outcome After Steroid Withdrawal in Pediatric Renal Transplant Patients Receiving Tacrolimus-Based Immunosuppression.

“…In order to minimize their well-described side effects, there have been a number of attempts to reduce the dosage of corticosteroids, particularly after the advent of cyclosporine, when further reduction in the maintenance dosage was possible. Several trials have been undertaken to evaluate the outcome of corticosteroid withdrawal in patients receiving cyclosporine-based immunosuppression, with, in the end, not completely satisfactory results and an unacceptably high incidence of late rejection (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Most renal transplant patients still receive maintenance corticosteroids chronically.…”

Renal Transplantation

“…Lowering antirejection drug doses with the aim to reduce the devastating side effects of long-term use of steroids and CsA has been attempted before with controversial outcomes (6). In most studies, steroid withdrawal from a triple immunosuppressive regimen of prednisone, CsA, and azathioprine at different intervals from transplantation was associated with large variability in the incidence of acute rejection, ranging from 14 to 60% (22)(23)(24)(25)(26)(27). Others, through the Canadian multicenter trial of steroid withdrawal 3 mo after kidney transplantation, reported increased graft loss in the steroid discontinuation group after 5 yr of follow-up (28).…”

Hypertension and renal dysfunction in long-term liver transplant recipients

“…Hricik et al 22 showed a significant reduction in mean arterial blood pressure after steroid withdrawal. The mechanism by which CyA causes hypertension has been investigated in many studies.…”