ABSTRACT
The attributable impact of the restoration of renal function on nitrogen balance in the KTR has been confounded by the requisite use of immunosuppressive therapy. The latter has been well known to independendy influence protein turnover. In particular, glucocorticoids have been repeatedly shown to increase protein catabolic rate (PCR) and result in negative nitrogen balance. Over a decade agp, multiple investigators demonstrated that PCR doubled within 6-11 days post-renal transplantation, independent of protein intake and in parallel with changes in steroid dose. Studies reported that despite restoration of renal function and intake of at least 1.2 gm protein/kg IBW/day, glucocorticoid therapy had a major impact on PCR and was associated with dramatic nitrogen wasting.
