Effects of a large dose of methylprednisolone on renal function.

Abstract

Simultaneous clearances of inulin (Ci”), creatinine (C,,), and para-aminohippurate (CPah) were measured in volunteer subjects and renal allograft recipients during a 48-hour period after the intravenous administration of 1 Gm. of methylprednisolone. Significant increases in Ci, and Cpah were noted in normal subjects at 24 hours; no significant change occurred in renal allograft recipients. Ci,/C,, ratios remained unchanged in both normal subjects and renal allograft recipients. These data demonstrate no long-term detrimental effect of a single, large dose of methylprednisolone on renal function in normal subjects or in renal allograft recipients. L arge, intermittent, intravenous doses of corticosteroids are clinically and experimentally effective in controlling renal allograft rejection.lms Woods and associates3 have observed minimal stigmata of hypercorticism and a low incidence of complications, including wound healing and gastrointestinal problems, in patients treated with large, daily, intravenous doses of methylprednisolone rather than with high oral doses of steroids. Recently, Webel and co-workers4 have demonstrated that 1 Gm. of methylprednisolone administered intravenously profoundly inhibited lymphocyte transformation in normal subjects ; the response lasted up to 72 hours. This finding suggests that large, intravenous doses of corticosteroids should be efficacious in controlling primarily cell-mediated immunologic reactions such as allograft rejection. A recent study raised questions regarding the use of large, intravenous doses of corticosteroids in treating renal allograft rejection. Popovtzer and associates5 demonstrated an immediate suppression of glomerular filtration rate and effec