Sirolimus Monotherapy Effectiveness in Liver Transplant Recipients With Renal Dysfunction Due to Calcineurin Inhibitors
| Autor: | Nicola De Ruvo, Gianni Cappelli, Roberto Montalti, Mario Spaggiari, Stefano Di Sandro, Fabrizio Di Benedetto, Giorgio Enrico Gerunda, Roberto Ballarin |
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| Přispěvatelé: | Di Benedetto, Fabrizio, Di Sandro, Stefano, De Ruvo, Nicola, Spaggiari, Mario, Montalti, Roberto, Ballarin, Roberto, Cappelli, Gianni, Gerunda, Giorgio E |
| Rok vydání: | 2009 |
| Předmět: |
Blood Glucose
Male Kidney Disease medicine.medical_treatment Liver transplantation Kidney Cohort Studies immunology Immunosuppressive Agent chemistry.chemical_compound Sirolimu Kidney transplantation Hypertriglyceridemia Calcineurin Gastroenterology Immunosuppression Middle Aged adverse effects/therapeutic use Treatment Outcome Creatinine Tacrolimu chemically induced Cyclosporine Kidney Diseases Immunosuppressive Agents Glomerular Filtration Rate Human Adult Aged Blood Glucose drug effects/metabolism Calcineurin antagonists /&/ inhibitors Cohort Studies Creatinine blood Cyclosporine adverse effects Glomerular Filtration Rate drug effects Humans Hypercholesterolemia chemically induced Hypertriglyceridemia chemically induced Immunosuppressive Agents adverse effects/therapeutic use Kidney Diseases chemically induced/prevention /&/ control Kidney drug effects Liver Transplantation immunology Male Middle Aged Sirolimus adverse effects/therapeutic use Tacrolimus adverse effects Treatment Outcome Adult medicine.medical_specialty Hypercholesterolemia Calcineurin Inhibitors Urology Renal function Tacrolimus Nephrotoxicity antagonists /& blood Internal medicine medicine Humans Aged Sirolimus control business.industry medicine.disease inhibitors Liver Transplantation Endocrinology chemically induced/prevention /& chemistry drug effects adverse effects Trough level Cohort Studie drug effects/metabolism business |
| Zdroj: | Journal of Clinical Gastroenterology. 43:280-286 |
| ISSN: | 0192-0790 |
| DOI: | 10.1097/mcg.0b013e3181739ff8 |
| Popis: | Introduction: Among the adverse effects of different calcineurin inhibitors (CIs), nephrotoxicity is the most common (incidence: 18.1 % at 13 y from liver transplantation) and depends on a variable degree of tubular-interstitial injury accompanied by focal glomerular sclerosis. A new immunosuppressive drug was introduced in solid organ transplant management, Sirolimus (SRL). It is a non-nephrotoxic immunosuppressor. Methods: Twenty-six patients who developed nephrotoxicity owing to CIs, showing an increment of serum creatinine levels ( > 1.8 mg/dL) were switched to SRL monotherapy, initially at a dosage between 3 and 5 mg/d, and subsequently adapted to achieve trough level between 8 to 10ng/mL. Results: Patients were followed-up for a mean period of 40.3 months (range, 8.4 to 76.7) from liver transplantation. Mean follow-up after switch was 27.5 months (range, 2 to 71.2). Immunosuppression therapy was converted after a mean period of 12.8 months (range, 0.2 to 43.4). Serum creatinine, urea, and estimated glomerular filtration rate were significantly improved. Discussion: Patients developing renal dysfunction after liver transplantation may be successfully treated by conversion from CI to SRL. Hypertriglyceridemia and hypercholesterolemia represent the principal side effects from SRL, but are treatable. Furthermore, SRL can significantly improve glucose tolerance. |
| Databáze: | OpenAIRE |
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