Long-term effects on renal function of dose-reduced calcineurin inhibitor and sirolimus in cardiac transplant patients.
Clin Transplant
; 26(1): 42-9, 2012.
Article
in En
| MEDLINE
| ID: mdl-21303417
ABSTRACT
UNLABELLED Calcineurin inhibitor (CNI)-associated renal insufficiency is common after cardiac transplantation (CTX); however, the addition of sirolimus allows for CNI dose reduction and this strategy may limit CNI renal toxicity. This study examines the long-term effects of such a strategy. METHODS:
Patients from a single center who had CTX from 1990 to 2007 and who were converted to sirolimus and a dose-reduced CNI were compared to group-matched controls maintained on CNI and an antiproliferative agent.RESULTS:
One hundred and fifty-five patients (79 sirolimus and 76 controls) were included and had similar baseline characteristics. Sirolimus was started a mean of 1429 d post-CTX and maintained for a mean of 823 d. Reason for conversion to sirolimus was renal insufficiency (34%), vasculopathy (29%), recurrent rejection (19%), and other (18%). The eGFR was not different between groups at baseline (44.7 mL/min/1.73 m(2) vs. 46.0, p = 0.64) or at any point during follow-up 90 d, 180 d, 1 yr, 2 yr, and 3 yr.conclusion:
Patients converted to a regimen of sirolimus and a dosed-reduced CNI have stable renal function over the following three yr, but do not have an improvement in renal outcomes compared to patients maintained on full dose CNI.
Full text:
1
Database:
MEDLINE
Main subject:
Heart Transplantation
/
Sirolimus
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Calcineurin Inhibitors
/
Graft Rejection
/
Immunosuppressive Agents
/
Kidney Failure, Chronic
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
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Male
/
Middle aged
Language:
En
Year:
2012
Type:
Article