Steroid Withdrawal Based on Lymphocyte Sensitivity to Endogenous Steroid in Renal Transplant Recipients

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We assessed lymphocyte sensitivity to endogenous cortisol and administered steroid as a biomarker for determining the safety of steroid withdrawal in renal transplant patients. Serum creatinine levels increased in a significantly higher number of patients hyposensitive to cortisol and administered steroid than in normally sensitive patients. The patients who have the normal sensitivity of endogenous cortisol and administered steroid, can withdraw steroid more safely. We considered that the highly cortisol-sensitive patients could be sufficiently immunosuppressed by their intrinsic cortisol which will recover after withdrawal of the administrating steroid, and that highly administered steroid -sensitive patients could get to reduce steroid easily. The lymphocyte sensitivity to cortisol and administered steroid may be a useful biomarker for selecting patients who can sustain steroid withdrawal.