Effect of Pregnancy on Long‐Term Kidney Function in Renal Transplant Recipients Treated with Cyclosporine and with Azathioprine
| Autor: | Barbara Schmalfeldt, Michael Barenbrock, Hans P. Schobel, Hans-Hellmut Neumayer, Stefan Paepke, Barbara C. Lattrell, Thorsten Fischer, Klemens Budde, Karl T.M. Schneider, Stephanie Pildner von Steinburg, R Fischer, Volker R. Jacobs |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Urology Renal function Azathioprine Kidney Function Tests chemistry.chemical_compound Pregnancy medicine Humans Immunology and Allergy Pharmacology (medical) Transplantation Creatinine Kidney business.industry Graft Survival Pregnancy Outcome Immunosuppression medicine.disease Kidney Transplantation Survival Analysis Surgery medicine.anatomical_structure chemistry Cyclosporine Female business Immunosuppressive Agents Follow-Up Studies Kidney disease medicine.drug |
| Zdroj: | American Journal of Transplantation. 5:2732-2739 |
| ISSN: | 1600-6135 |
| Popis: | In order to investigate the effect of different immunosuppressive regimens and the time interval between transplantation and pregnancy on long-term outcome, we performed a case-control study in pregnant renal allograft recipients. Eighty-one pregnancies of kidney transplanted recipients were identified [cyclosporine (CYA): n = 40; azathioprine (AZA): n = 41]. Controls were matched with respect to important prognostic factors. Posttransplant follow-up was 91.3 +/- 5 months. Graft and patient survival were similar in both groups and there was no apparent effect of immunosuppression. A total of 28 recipients (33%) delivered within 2 years and 6 (8%) subjects within 1 year after transplantation, but these short transplantation-to-pregnancy intervals had no apparent adverse effect on long-term outcome. In contrast to AZA-treated patients, CYA-treated patients experienced an increase in serum creatinine postpartum (1.15 +/- 0.2 mg/dL vs. 1.61 +/- 0.1 mg/dL; p0.05). Whole blood CYA levels decreased transiently during pregnancy from 115.9 +/- 8 ng/mL to 80.7 +/- 7 ng/mL leading to a gradual increase in drug dose from 240 +/- 14 mg/day to 324 +/- 21 mg/day (p0.05). Following delivery, there was an increase in CYA concentrations to 173 +/- 5.4 ng/mL, requiring rapid dose tapering to baseline of 246 +/- 15 mg/day. Pregnancies in renal recipients do not affect long-term patient and graft survival, independent of the immunosuppression. No detrimental effect of short transplantation-to-pregnancy intervals on long-term graft function was detected. |
| Databáze: | OpenAIRE |
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