1988 Volume 79 Issue 9 Pages 1550-1554
In order to evaluate the long-term integrity of adrenocortical function, a study has been carried out in nine renal transplant recipients followed for 5 to 17 years after surgery. Their age was 24.3 years (range 10 to 32 years). Conventional immunosuppression with steroids and azathioprine was applied in all instances. At the end of the 2nd year, steroids were completely stopped if renal funciton was normal and if no alterations were seen on renal biopsy. Adrenocortical function tests were repeated serially at 1-year intervals after transplantation. The mean serum 11-hydroxycorticosteroid (11-OHCS) was 23.0±2.3μg/dl in 3 patients without steroids and 6.3±1.8μg/dl in 6 patients on steroids (p<0.003). A positive increase in serum 11-OHCS was produced by a standard 8 hour intravenous corticotropin (ACTH) test in 2 out of 3 patients without steroids and in 3 out of 6 patients with steroids. In all 3 patients with normal graft function (GFR>70ml/min) serum cortisol and 11-OHCS, and urinary 17-hydroxycorticosteroid and 17-ketosteroid (17-KS) were within normal limits. However, only 1 out of 6 patients with renal dysfunction (GFR<70ml/min) had normal serum 11-OHCS and urinary 17-KS. The results observed in this clinical study indicate that adrenocortical function was significantly suppressed in the patients on long-term steroid therapy.
