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Brand names: Deltasone / Rayos • Drug class: Corticosteroid
Prednisone is the oldest and most versatile drug in kidney care — high doses stop kidney inflammation in glomerular disease and rejection; low doses maintain transplant immunosuppression. Its side effects (glucose, bone, mood, weight) are the management challenge.
Prednisone works in nearly every immune kidney disease — minimal change disease, FSGS, IgA nephropathy, lupus nephritis, ANCA vasculitis, and transplant maintenance. It is always tapered, because abrupt stops cause flares and adrenal insufficiency.
Steroids are first-line in minimal change disease and high-risk IgA nephropathy (TESTING trial)
TESTING (JAMA 2022), 2022
Low-dose steroid maintenance is part of standard transplant regimens (with steroid-sparing protocols for lower-risk patients)
Transplant literature, 2000s-present
Pulse steroids treat most acute cellular rejection episodes
Rejection treatment literature, 1980s-present
No eGFR-based dosing — steroids are metabolically cleared. Doses are managed by taper and disease response; bone protection (calcium, vitamin D) and glucose screening accompany long courses.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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