Improvement of Renal Graft Function After Conversion From a Calcineurin Inhibitor Including Immunosuppression to a Mycophenolate Sodium Including Regimen: A 4-year Follow-up
| Autor: | Gerhard A. Mueller, Michael Koziolek, J. Muehlhausen, M.H.J. Heeg, Carsten P. Bramlage, Andreas Leha, K. Homayounfar |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Calcineurin Inhibitors 030232 urology & nephrology Urology Renal graft 030204 cardiovascular system & hematology Kidney urologic and male genital diseases 03 medical and health sciences 0302 clinical medicine medicine Humans Transplantation Homologous Retrospective Studies Immunosuppression Therapy Transplantation business.industry Graft Survival Mycophenolate Sodium Immunosuppression Middle Aged Mycophenolic Acid Kidney Transplantation 3. Good health Surgery Calcineurin Regimen Treatment Outcome surgical procedures operative Toxicity Kidney Failure Chronic Female Graft survival business Immunosuppressive Agents Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | Transplantation Proceedings. 45:142-147 |
| ISSN: | 0041-1345 |
| DOI: | 10.1016/j.transproceed.2012.10.028 |
| Popis: | The most common immunosuppressive regimens after renal transplantation include calcineurin inhibitors (CNI). However, due to renal toxicity long-term graft survival does not seem to be positively affected by CNIs.In the present study, we investigated 17 patients, in which the CNI immunosuppression was converted to a CNI-free, mycophenolate sodium (MPS) regimen. Conversion was performed due to progressive impairment of the graft function from suspected CNI toxicity. We retrospectively analyzed graft function as well as toxicity and surrogate markers for 4 years before and 4 years after conversion using a repeated-measures mixed model data analysis and/or a paired sample t-test.The mean time point of therapy conversion was 11.2 ± 4.6 years after transplantation. Within 1 month of CNI discontinuation, allograft function improved significantly, remaining at a significant level for 2 years. The estimated glomerular filtration rate increased from 43.4 ± 14.8 to a maximum of 55.7 ± 21.7 mL/min at 1 year after conversion (P = .0027). After 4 years, the end of the observation period, renal function was similar to the baseline. There were no significant side effects.These data suggested that, when chronic CNI-toxicity is suspected, renal allograft recipients may benefit from CNI withdrawal in favor of a MPS-including immunosuppressive regimen. |
| Databáze: | OpenAIRE |
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