| Title: |
Conversion from calcineurin inhibitors to sirolimus in kidney transplant recipients: a retrospective cohort study |
| Authors: |
Cardinal, Heloïse; Froidure, Antoine; Dandavino, Raymond; Daloze, Pierre; Hébert, Marie-Josée; Colette, Suzon; Boucher, A |
| Contributors: |
UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie |
| Source: |
Transplantation Proceedings, Vol. 41, no.8, p. 3308-3310 (October 2009) |
| Publisher Information: |
Elsevier Inc. |
| Publication Year: |
2009 |
| Collection: |
DIAL@USL-B (Université Saint-Louis, Bruxelles) |
| Description: |
BACKGROUND: Replacing a calcineurin inhibitor (CNI) with sirolimus (SRL) may preserve kidney graft function. However, at the present time, only short follow-up after conversion is available. The aim of this study was to assess whether conversion from a CNI-based to an SRL-based maintenance regimen was safe and effective. MATERIALS AND METHODS: We performed a retrospective cohort study among kidney graft patients whose CNI was withdrawn to be replaced by SRL. Two-tailed paired t tests were used to compare glomerular filtration rates (GFRs) and proteinuria levels before and up to 2 years after conversion. We used linear regression to determine the factors associated with changes in renal function after conversion. RESULTS: The 193 study subjects had a mean GFR at conversion of 41 +/- 16 mL/min/1.73 m(2) a median proteinuria level of 0 g/L (interquartile range = 0-0.15). After conversion, the GFR was stable: at 1 year, the change was -0.34 mL/min/1.73 m(2) (95% confidence interval [CI] = -2.71, 2.03) and at 2 years, -0.96 mL/min/1.73 m(2) (95% CI = 4.26, 2.34). There was a small but significant increase in dipstick proteinuria at 1 year of +0.5 g/L, (95% CI = 0.20, 0.75). On multivariate analysis, proteinuria > or = 1 g/L at the time of conversion was the only predictor of deteriorating GFR at 1 year (beta: -7.91 mL/min/1.73 m(2); 95% CI = -14.10, -1.70). SRL had to be discontinued in 31% of patients. CONCLUSION: Conversion from CNI to SRL resulted in stable graft function at 2 years and in a slight increase in proteinuria. Despite the relatively high reconversion rate, this strategy offers a reasonable alternative to CNIs for most patients. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
boreal:125042; http://hdl.handle.net/2078/125042 |
| Availability: |
http://hdl.handle.net/2078/125042 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.ED41FCA |
| Database: |
BASE |