A search for optimizing corticosteroid administration to renal transplant patients

To minimize the side effects without interfering with the immunosuppressive effectiveness of corticosteroids, we gave methylprednisolone (MP) by a schedule respecting the circadian cortisol secretion to 86 cadaveric renal transplant recipients. In addition, to evaluate the importance of the steroid dose in early maintenance therapy, we randomly allocted the patients to our standard dose of MP or to a low-dose regimen. Although patient and graft survival rates and the incidence of side effects were similar in the two groups, the SD we used was more effective in preventing rejection, thus SD we used was more effective in preventing rejection, thus indicating that steroids are indeed immunosuppressive in renal transplant patients.