Clinical effect of conversion to Rapamycin on chronic allograft nephropathy / 中华器官移植杂志

ABSTRACT

Objective To study the effect and safety of conversion from calcineurin inhibitors to rapamycin in kidney transplantation recipients with chronic allograft nephropathy.Methods In 82 kidney transplant recipients enrolled in this study,72 cases were diagnosed as having chronic allograft nephropathy by biopsy.Recipients (SRL group) were administered with rapamycin after withdrawal of calcineurin inhibitors.The doses of CNI in other recipients (non-SRL group) were not changed.Renal function,proteinuria,blood pressure,blood fat,hepatic function and hemogram were observed for 24 months in each group.Results During the follow-up period,serum creatinine level was dropped significantly in SRL group (P＜0.05),but it was increased in non-SRL group (P＜0.05).SRL group showed increased proteinuria,serum cholesterol and triglycerides (P＜0.05),and reduced Plt (P＜0.05).According to the renal function before conversion,the recipients who were administered rapamycin divided into four groups.In group A (Scr ＜ 120 μmol/L),there was no significant difference in diverse variables before and after conversion.In group B (Scr 120-200 μmol/L and Banff Ⅰ-Ⅱ),renal function was improved,and proteinuria alleviated.In group C (Scr 120-200 μmol/L and Banff ＞ Ⅱ),and group D (Scr ＞200 μmol/L),renal function was damaged to varying degrees and proteinuria was deteriorated.Conclusion It is safe and effective for patients with chronic allograft nephropathy to convert from calcineurin inhibitors to rapamycin.