Conversion from Calcineurin Inhibitor to Sirolimus for Renal Function Deterioration in Kidney Allograft Recipients
Autor: | Jorge Estrada-Oros, Gustavo Martínez-Mier, Gustavo F. Mendez-Machado, Marco T Méndez-López, Luis F Budar-Fernández, Julio Cesar Viñas Dozal, Juan I. Soto-González |
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Rok vydání: | 2006 |
Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Calcineurin Inhibitors Urology Renal function Nephrotoxicity Hemoglobins chemistry.chemical_compound Chronic allograft nephropathy medicine Humans Transplantation Homologous Urea Enzyme Inhibitors Kidney transplantation Monitoring Physiologic Retrospective Studies Sirolimus Creatinine Kidney business.industry Graft Survival General Medicine medicine.disease Kidney Transplantation Surgery Calcineurin Treatment Outcome surgical procedures operative medicine.anatomical_structure chemistry Cyclosporine Potassium Kidney Failure Chronic Calcium Female business Immunosuppressive Agents medicine.drug |
Zdroj: | Archives of Medical Research. 37:635-638 |
ISSN: | 0188-4409 |
DOI: | 10.1016/j.arcmed.2005.12.003 |
Popis: | Calcineurin inhibitors play an important role in chronic allograft dysfunction. Sirolimus is an interesting alternative in renal transplant patients because it is less nephrotoxic than calcineurin inhibitors.A chart review of the clinical outcome of kidney transplant patients converted to sirolimus with progressive allograft dysfunction is reported herein. Fifteen patients (average age: 32.3 years, 44 months mean time of conversion) were included. Indication for conversion was a20% increase in serum creatinine over the last 6 months or progression to the range of 2-4.5 mg/dL. Patients underwent abrupt cessation of cyclosporine and sirolimus addition at 2-5 mg/day.Concomitant immunosuppression remained unchanged during conversion. Targeted sirolimus level was 8-12 ng/mL. Serum creatinine dropped from pre-conversion level of 2.75 +/- 0.83 to 2.14 +/- 0.67 and 1.97 +/- 0.66 mg/dL at 3 and 6 months (p0.05). There was a significant decrease in blood urea nitrogen, hemoglobin and serum calcium at 3 months post-conversion as well as serum calcium and potassium at 6 months post-conversion (p0.05). There were no rejection episodes. Patient and graft survival was 100% with three infectious complications.Monitored sirolimus conversion with sharp withdrawal of calcineurin inhibitor is an alternative for patients with deteriorating renal function and chronic allograft nephropathy. |
Databáze: | OpenAIRE |
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