Glucocorticoids in nephrology II: indications and dosage

Abstract

Present article describes glucocorticoid prescriptions in nephrology and renal transplantation, the dosages in induction and maintenance treatment phases and discontinuation. Key evidence and landmark trials are referenced, to establish the basis for modern glucocorticoid application in specific kidney disease indications. The glucocorticoid regimens in IgA glomerulonephritis, major primary glomerular diseases with nephrotic syndrome, vasculitides and tubulointerstitial nephritis are described. Various schemes for glucocorticoid dosage in lupus nephritis are given. The evolution of glucocorticoid usage in kidney transplantation is delineated and the modern role of these drugs in renal transplantation is defined. There are attempts to replace glucocorticoids with adrenocorticotrophic hormone in some glomerular diseases. Despite being relatively old drugs and having numerous side effects, glucocorticoids still function as major therapeutic agents for specific immunosuppressive treatment in nephrology.

Keywords

• synthetic glucocorticoids
• immunosuppression
• glomerulonephritis
• systemic lupus erythematosus
• kidney transplantation