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ORIGINAL ARTICLE
Year : 2017  |  Volume : 17  |  Issue : 2  |  Page : 43-51

Corticosteroid in kidney transplant immunotherapy: rid off the giant


1 Renal Unit, Department of Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State; Institute of Medical Sciences, University of Liverpool, Liverpool, Nigeria
2 Institute of Medical Sciences, University of Liverpool, Liverpool, UK
3 Institute of Medical Sciences, University of Liverpool, Liverpool; Royal Liverpool University Hospitals, University of Liverpool, Liverpool, UK
4 Institute of Medical Sciences, University of Liverpool, Liverpool; Renal Unit, Sheffield Teaching Hospitals, University of Sheffield, Sheffield, UK

Correspondence Address:
Ahmed Halawa
Renal Unit, Sheffield Teaching Hospital, University of Sheffield, Sheffield
UK
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jesnt.jesnt_16_17

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Corticosteroid use to prevent rejection is ancient but pivotal in transplant immunotherapy. Its benefits are worrisomely being negated by its numerous side effects that affect the quality of life and add to the cost of treatment among transplant patients. The past three decades has witnessed an important dynamism with the advent of many other immunosuppressive agents in various combination protocols, which has led to reports of reduction in episodes of acute rejection. This, in addition to side effects, has raised the question of the need for chronic use of steroid or its avoidance from outset. The benefits of steroid-sparing are compelling especially in low-risk recipients and, recently, paediatric patients. The burden of cardiovascular diseases, the major cause of death in transplant patients, osteopenia and impaired growth among paediatrics confront both patients and their carers. Of concern, however, has been the variation and quality of study designs, which has made the report not only inconsistent but with weak evidence as well. The question still remains whether corticosteroid is disposable. We review corticosteroid use in transplant immunotherapy in the era of improved immunosuppression.


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