Preservation of graft function in low-risk living kidney transplant recipients treated with a combination of sirolimus and cyclosporine
Braz. j. med. biol. res
;
37(9): 1303-1312, Sept. 2004. tab, graf
Artículo
en Inglés
| LILACS
| ID: lil-365224
ABSTRACT
The use of sirolimus (SRL) in combination with full doses of cyclosporin A (CsA) results in reduced one-year kidney allograft function, which is associated with shorter long-term allograft survival. We determined the effect of reduced CsA exposure on graft function in patients receiving SRL and prednisone. Ninety recipients of living kidney transplants receiving SRL (2 mg/day, po) were compared to 35 recipients receiving azathioprine (AZA, 2 mg kg-1 day-1, po). All patients also received CsA (8-10 mg kg-1 day-1, po) and prednisone (0.5 mg kg-1 day-1). Efficacy end-point was a composite of biopsy-confirmed acute rejection, graft loss, or death at one year. Graft function was measured by creatinine, creatinine clearance, and graft function deterioration between 3 and 12 months (delta1/Cr). CsA concentrations in patients receiving SRL were 26 percent lower. No differences in one-year composite efficacy end-point were observed comparing SRL and AZA groups (18 vs 20 percent) or in the incidence of biopsy-proven acute rejection (14.4 and 14.3 percent). There were no differences in mean ± SD creatinine (1.65 ± 0.46 vs 1.60 ± 0.43 mg/dl, P = 0.48) or calculated creatinine clearances (61 ± 15 vs 62 ± 13 ml/min, P = 0.58) at one year. Mean ± SD delta1/Cr (-11 ± 17 vs -14 ± 15 percent, P = 0.7) or the percentage of patients with >20 percent (26 vs 31 percent, P = 0.6) or >30 percent delta1/Cr (19 vs 17 percent, P = 1) did not differ between the two groups. The use of 2-mg fixed oral doses of SRL and reduced CsA exposure was effective in preventing acute rejection and preserving allograft function.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Prednisona
/
Trasplante de Riñón
/
Ciclosporina
/
Sirolimus
/
Rechazo de Injerto
/
Inmunosupresores
Tipo de estudio:
Estudio de etiología
/
Factores de riesgo
Límite:
Adolescente
/
Adulto
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Braz. j. med. biol. res
Asunto de la revista:
Biologia
/
Medicina
Año:
2004
Tipo del documento:
Artículo
/
Congreso y conferencia
País de afiliación:
Brasil
Institución/País de afiliación:
Laboratórios Wyeth-Ayerst do Brasil/BR
/
Universidade Federal de São Paulo/BR
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