How does prednisone affect your kidneys?

In this article:

• Prednisone and kidneys
• Dosage
• Side effects
• Tips for taking prednisone
• The bottom line

In this article

• Prednisone and kidneys
• Dosage
• Side effects
• Tips for taking prednisone
• The bottom line

Prednisone is a commonly prescribed steroid, or corticosteroid, medication that can be used in the treatment of many conditions, such as arthritis, allergic reactions, multiple sclerosis (MS), lupus, and certain cancers. It works on the immune system to decrease inflammation (swelling) associated with certain conditions. Prednisone affects many systems in the body, including the kidneys. By reducing inflammation, prednisone can help prevent or slow down the progression of kidney damage in people with certain types of kidney problems. It can also be used to prevent the body from rejecting a kidney transplant. Continue reading to learn more about prednisone and its uses for the kidneys.

How does prednisone support renal function?

According to the American Kidney Fund and the National Kidney Foundation, prednisone can help the kidneys in various ways.

Prednisone can help prevent organ rejection after a kidney transplant. The body’s immune system sees a transplanted organ as a foreign object and tries to attack it. Prednisone can help control the immune system, preventing it from attacking a transplanted kidney or other organ.

Nephrotic syndrome is a group of symptoms that indicate problems with kidney function, including protein in the urine (proteinuria), low levels of albumin in the blood, swelling, and high cholesterol. Prednisone is often the first treatment of choice for managing nephrotic syndrome. It can help control various underlying kidney conditions that cause nephrotic syndrome, thereby reducing symptoms and helping to prevent complications. These conditions include:

• Focal glomerulosclerosis: A condition that affects the glomeruli, tiny structures in the kidneys that filter blood, leading to scarring. This is the most common cause of nephrotic syndrome in Black adults.
• Minimal change disease: A condition that is associated with damage to the glomeruli. This is the most common cause of nephrotic syndrome in children. While the disease’s cause is unknown, it may happen after an allergic reaction or infection. 
• IgA nephropathy: Also known as Berger’s disease, IgA nephropathy is an autoimmune disease that occurs when IgA and other antibodies cause inflammation and kidney damage. This can cause the kidneys to leak blood and protein into the urine. 

Optimal dosage for kidney protection

While many drugs have very clear dosages for specific uses, prednisone has dozens of uses, and dosing is individualized to each patient. The healthcare provider will determine the dosage based on factors such as the condition being treated, other medical conditions, and the response to treatment. Healthcare providers prescribe the lowest effective dose of prednisone. While taking prednisone, your healthcare provider will monitor you closely. Always follow the dosing instructions from your healthcare provider and take prednisone exactly as directed. 

To avoid withdrawal symptoms, you should not stop taking prednisone abruptly. Withdrawal symptoms may include tiredness, body aches, and joint pain. Stopping prednisone suddenly can also cause adrenal insufficiency, where the body cannot produce enough natural corticosteroids. It’s important to decrease the dose of prednisone gradually under the supervision of a healthcare provider to prevent these issues.

Dosage for kidney transplant rejection prevention: Generally, to prevent rejection after a kidney transplant, the prednisone dosage may range from 5 milligrams (mg) to 30 mg by mouth once a day, along with other medication. The length of treatment will depend on individual circumstances, and when it is time to stop taking the medicine, your healthcare professional will provide you with a tapering schedule. 

Dosage for treatment of proteinuria in nephrotic syndrome: Adults are generally prescribed a dosage of 40 to 80 mg per day, taken every day until there is no longer protein in the urine. After this, prednisone may need to be continued at a lower dose as a long-term treatment, although some people may be able to slowly taper off the medicine under the guidance of a healthcare provider. In children and adolescents, the dose is calculated by body weight, up to 80 mg daily, until there is no protein in the urine for three days. Then, the dosage may be decreased to every other day, with the length of treatment determined by the healthcare provider. 

Side effects of prednisone

Prednisone can cause various adverse effects. Common side effects may include:

• Headache 
• Dizziness
• Trouble sleeping
• Mood swings/personality changes
• Hypertension (high blood pressure)
• Bulging eyes
• Acne
• Increased appetite and weight gain
• Thin and fragile skin
• Red or purple spots under the skin
• Slowed healing
• Increased hair growth
• Changes in body fat distribution
• Feeling very tired and/or weak
• Irregular or absent menstrual periods
• Decreased libido
• Heartburn
• Sweating 

Taking high-dose prednisone or taking it for longer periods of time can increase the risk of side effects, including serious side effects. For example, because prednisone is an immunosuppressive medicine (suppresses the immune system), people who take it are at higher risk of infection. Prednisone can also cause other long-term side effects like glaucoma, high blood sugar or diabetes, and osteoporosis. You can talk with your healthcare provider for more information about the risks and benefits of prednisone, as this is not a full list of side effects.

Tips for taking prednisone

While side effects can still occur, here are some tips for taking prednisone as safely as possible. 

• Before taking prednisone, tell your healthcare provider about all of your medical conditions (including if you are pregnant or breastfeeding) and medical history, as well as all of the medications you take, including prescription and OTC drugs, vitamins, and supplements. 
• Follow the dosing directions exactly. Do not take more medicine than prescribed. If you do not know how much prednisone to take, ask your healthcare provider or pharmacist. 
• Do not stop taking prednisone abruptly because stopping steroid treatment suddenly could cause withdrawal symptoms as well as adrenal gland problems.
• Keep all appointments with your healthcare provider and lab for follow-up and blood work. It is important to be closely monitored while taking prednisone.
• Take prednisone with food to reduce the incidence of gastrointestinal side effects.
• Your healthcare provider will advise you of any dietary changes you should make, such as following a low-salt or high-calcium diet or taking a vitamin or supplement. 
• While taking prednisone, avoid people who are sick. In particular, avoid people with chickenpox or measles. If you are exposed to someone with chickenpox or measles, call your healthcare provider right away. 
• You should not get live vaccines while taking prednisone. However, many other vaccines may be fine for you to get while on prednisone. Check with your healthcare provider before getting any vaccines.
• Tell all healthcare providers you see—including dentists, doctors, and surgeons—that you are taking prednisone. 

The bottom line

Prednisone is a steroid medicine used to treat various medical conditions, including conditions that affect the kidneys. Prednisone is commonly prescribed to help prevent organ rejection after a transplant, as well as to treat certain kidney diseases. Because this medicine is associated with many potential side effects, some of which can be serious, it is important to take prednisone exactly as directed by your healthcare provider and keep all appointments for follow-up and blood work. Always consult your healthcare provider with questions or concerns about your medication.