ABSTRACT

Chronic kidney disease is one of the leading diseases with an increasing prevalence corresponding with the increasing prevalence of diabetes mellitus, hypertension, obesity, and metabolic syndrome, changing dietary habits, and prolongation in the average lifespan. Together with its high morbidity and mortality, it is a significant burden for the country’s economy. Renal transplantation is accepted as the best treatment modality for end-stage renal disease (ESRD). Steroids are the basic immunosuppressive agents that are used both as maintenance therapy and for management of the acute rejections. Although steroids reduce the frequency of acute rejections and lengthen the graft survival, their long-term use causes increased patient mortality and morbidity. Therefore, maintenance regimens excluding steroids are becoming increasingly popular. However, the results of the studies examining the metabolical advantages and graft survival by excluding steroids are conflicting. Thus, instead of proposing standard regimens without steroids, it seems more acceptable to evaluate each patient individually and to implement the treatment to carefully selected patients.

Keywords: Immunosuppression, chronic kidney disease, renal transplantation, steroid