Tubular dysfunction in renal transplant patients using sirolimus or tacrolimus
| Autor: | Carlos Perez Gomes, Maurilo Leite, Pedro B Banhara, Alvimar G. Delgado, Renato Torres Gonçalves, Pedro Túlio Monteiro de Castro e Abreu Rocha |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Urinary system Urology Tacrolimus Distal renal tubular acidosis Renal tubular dysfunction Humans Medicine Kidney transplantation Sirolimus urogenital system business.industry Acidosis Renal Tubular General Medicine Hydrogen-Ion Concentration Middle Aged medicine.disease Kidney Transplantation Calcineurin Kidney Tubules surgical procedures operative Nephrology Renal physiology Female business Immunosuppressive Agents medicine.drug |
| Zdroj: | Clinical Nephrology. 83:331-337 |
| ISSN: | 0301-0430 |
| Popis: | Background Tubular dysfunction is prevalent among kidney transplant patients using calcineurin inhibitors, but our knowledge of the tubular effects of mTOR inhibitors is more limited. Methods 60 kidney transplant outpatients using either the calcineurin inhibitor tacrolimus or the mTOR inhibitor sirolimus were investigated for renal tubular dysfunction. Proximal tubule function was assessed by quantification of albumin and β2-microglobulin, tubular reabsorption of phosphate and fractional excretion of bicarbonate. Distal tubular function was evaluated by water deprivation test and by urinary acidification test using furosemide and fludrocortisone for pH, ammonium and titratable acidity measurements. Results The prevalence of distal renal tubular acidosis (dRTA) was 17% for both treatment groups. 70% of patients treated with sirolimus and 94% using tacrolimus presented with urine concentrating defect (p=0.04). Conclusion Distal RTA and urine concentrating defect were highly prevalent after kidney transplantation both in the sirolimus and tacrolimus treated patients. Acidification test was essential for the appropriate diagnosis of dRTA while dipstick urine specific gravity test was able to detect urine concentrating defect in this population. |
| Databáze: | OpenAIRE |
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