Alternate-day prednisone therapy in recipients of renal allografts. Risk and benefits
A. G. Diethelm, W. A. Sterling, M. W. Hartley and J. M. Morgan
Forty-five patients receiving renal allografts were gradually converted
from daily to alternate-day prednisone therapy. Indications for conversion
included aseptic necrosis, growth retardation in children and adolescents,
obesity, diabetes, cataract formation, and cosmetic appearance. Eight of
the 45 patients developed acute or chronic rejection during or just after
completion of alternate-day steroid therapy. The remaining 37 patients had
a notable decrease in the degree of hypercorticism, with return of growth
in children and adolescents. However, there was no improvement once aseptic
necrosis or cataract formation had occurred. Although the use of
alternate-day prednisone therapy is of benefit in reducing the untoward
side effects of corticosteroids, the risk of precipitating allograft
rejection is a significant threat and must be carefully considered whenever
this form of treatment is undertaken.
