Long-Term Steroid-Based Therapy: Risk of Infectious Complications in Immunosuppressed Kidney-Transplant Recipients as Compared to the General Population

Steroids are used to treat chronic inflammatory diseases and are often given as part of an immunosuppressive therapy to prevent acute/chronic kidney-graft rejection. However, steroids have many side-effects and may increase the risk of infectious complications. This review reports on the infectious complications that occur in those within the general population that receive chronic steroid therapy compared to kidney-transplant recipients that receive steroids as part of their immunosuppressive regimen. Many studies show that patients with rheumatoid arthritis, asthma, chronic obstructive pulmonary disease, or inflammatory bowel disease, and treated for >90 days with a steroid-based therapy, have a significantly greater likelihood of developing a serious infectious complication. However, kidney-transplant recipients that receive long-term steroid therapy, when compared to those with steroid-free immuno suppression, have the same risk of developing an infectious complication: this may be because the current immunosuppressive drugs, such calcineurin inhibitors and mycophenolic acid, are so powerful that they offset the risks linked to steroids.