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2015 ; 8
(3
): 3552-8
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Five-year follow-up after conversion from calcineurin inhibitor to
sirolimus-based treatment in kidney transplant patients with chronic allograft
nephropathy
#MMPMID26064248
Xia SQ
; Fan Y
; Tan MY
; Zheng JH
Int J Clin Exp Med
2015[]; 8
(3
): 3552-8
PMID26064248
show ga
Chronic allograft nephropathy (CAN) is a major cause of graft loss in long-term
kidney transplant recipients. To identify the safety and efficacy of conversion
from calcineurin inhibitors (CNI) to sirolimus (SRL) in patients with CAN, we
investigated 92 biopsy demonstrated CAN patients during a 5-year follow-up.45
patients were converted to sirolimus treatment (SRL group) and remaining 47
patients continued CNI immunosuppression (CNI group). Renal function,
proteinuria, hepatic function, lipid level and blood routine examination were
observed for 60 months in each group. During the period of conversion, serum
creatinine was superior in SRL group to CNI group. It dropped significantly from
(174.0 ± 62.8) umol/L to (150.7 ± 83.4) umol/L in SRL group whereas increased to
(200.9 ± 73.5) umol/L in CNI group (P < 0.05). However, SRL group showed
increased proteinuria, triglycerides and decreased Plt (P < 0.05). We also found
those patients in SRL group with a good baseline of renal function (serum
creatinine < 200 umol/L or proteinuria < 800 mg/day at conversion) would
ameliorate the impaired renal function from CAN at 60 months. In conclusion, it
is safe and effective to convert from CNI to SRL for patients with CAN in our
long-term observation. Early conversion is associated with an improvement of
renal function.