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[Influence of intravenous steroid administration on kidney function]
Fortschritte Der Medizin
|March 18, 1976
Summary
High-dose steroid treatment, like Prednisolone, acutely reduces kidney function in transplant recipients. It impairs sodium reabsorption and affects filtration rate, making creatinine clearance unreliable.
Area of Science:
- Nephrology
- Pharmacology
- Transplantation Medicine
Background:
- Glucocorticoids, such as Prednisolone, are commonly used in kidney transplant recipients.
- Understanding the acute renal effects of high-dose steroids is crucial for patient management.
Purpose of the Study:
- To investigate the acute renal response to intravenous Prednisolone in kidney transplant recipients and healthy controls.
- To assess the impact of steroid infusion on glomerular filtration and tubular function.
Main Methods:
- Administration of 1.0 g Prednisolone intravenously.
- Measurement of glomerular filtration rate (GFR) using creatinine clearance (CCR) and inulin clearance (CIN).
- Assessment of effective plasma flow (CPAH) and tubular sodium reabsorption.
Main Results:
- Acute suppression of glomerular filtration rate (GFR) and effective plasma flow (CPAH) observed.
- Impaired proximal tubule sodium reabsorption directly linked to steroid infusion.
- Increased filtered fraction of potassium noted.
- Creatinine clearance (CCR) was found to be an unreliable marker of GFR under high-dose steroid treatment.
Conclusions:
- High-dose intravenous Prednisolone causes acute renal dysfunction in kidney transplant recipients.
- Steroid-induced impairment of sodium reabsorption and altered potassium handling are significant.
- Creatinine clearance (CCR) should be interpreted cautiously as an indicator of GFR during high-dose steroid therapy.