Effect of early conversion from CNI to sirolimus on outcomes in kidney transplant recipients with allograft dysfunction

Journal of Nephrology

Volumn 25, Issue 5, 2012, Pages 709-718

  Paoletti, Ernesto ^a   Ratto, Elena ^a   Bellino, Diego ^a   Marsano, Luigina ^a   Cassottana, Paolo ^a   Cannella, Giuseppe ^a  

^a UNIVERSITY OF GENOA   (Italy)

Author keywords

Allograft dysfunction; Calcineurin inhibitor; Kidney transplantation; Left ventricular hypertrophy; Outcome; Renal function; Sirolimus

Indexed keywords

CALCINEURIN INHIBITOR; CHOLESTEROL; CREATININE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PROTEIN; RAPAMYCIN; STEROID; TRIACYLGLYCEROL;

ACUTE CORONARY SYNDROME; ACUTE GRAFT REJECTION; ADULT; AGED; ARTICLE; CARDIOVASCULAR PARAMETERS; CEREBROVASCULAR ACCIDENT; CHOLESTEROL BLOOD LEVEL; CLINICAL ARTICLE; CONGESTIVE HEART FAILURE; CONTROLLED STUDY; CREATININE BLOOD LEVEL; DIASTOLIC INTRAVENTRICULAR SEPTUM THICKNESS; DIASTOLIC LEFT VENTRICULAR POSTERIOR WALL THICKNESS; DRUG DOSE TITRATION; DRUG SUBSTITUTION; DRUG WITHDRAWAL; ECHOCARDIOGRAPHY; EVENT FREE SURVIVAL; FEMALE; GLOMERULUS FILTRATION RATE; GRAFT RECIPIENT; HEART ATRIUM FIBRILLATION; HEART VENTRICLE HYPERTROPHY; HUMAN; IMMUNOSUPPRESSIVE TREATMENT; KIDNEY FAILURE; KIDNEY GRAFT REJECTION; LEFT VENTRICULAR MASS INDEX; LONG TERM SURVIVAL; LUNG TUMOR; LYMPHEDEMA; MALE; NEPHROTOXICITY; PERIPHERAL OCCLUSIVE ARTERY DISEASE; PREDICTIVE VALUE; PROTEIN URINE LEVEL; PULSE PRESSURE; RENAL GRAFT DYSFUNCTION; RENAL REPLACEMENT THERAPY; SKIN CANCER; TREATMENT OUTCOME; TRIACYLGLYCEROL BLOOD LEVEL;

ADULT; AGED; BIOPSY; CALCINEURIN; DISEASE-FREE SURVIVAL; DRUG ADMINISTRATION SCHEDULE; DRUG SUBSTITUTION; DRUG THERAPY, COMBINATION; FEMALE; GLOMERULAR FILTRATION RATE; GRAFT REJECTION; HEART DISEASES; HUMANS; IMMUNOSUPPRESSIVE AGENTS; KAPLAN-MEIER ESTIMATE; KIDNEY TRANSPLANTATION; LINEAR MODELS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; MYCOPHENOLIC ACID; POSTOPERATIVE COMPLICATIONS; PROPORTIONAL HAZARDS MODELS; RISK ASSESSMENT; RISK FACTORS; SIROLIMUS; STEROIDS; TIME FACTORS; TREATMENT OUTCOME;

EID: 84866989387     PISSN: 11218428     EISSN: 17246059     Source Type: Journal    
DOI: 10.5301/jn.5000044     Document Type: Article

References (37)

1. Flechner SM, Goldfarb D, Solez K, et al. Kidney transplantation with sirolimus and mycophenolate mofetil-based immunosuppression: 5-year results of a randomized prospective trial compared to calcineurin inhibitor drugs. Transplantation. 2007;83:883-892.
2. Kahan BD. Sirolimus-based immunosuppression: present state of the art. J Nephrol. 2004;17(Suppl.8):S32-S39.
3. Rostaing L, Kamar N. mTOR inhibitor/proliferation signal inhibitors: entering or leaving the field? J Nephrol. 2010;23: 133-142.
4. Cravedi P, Ruggenenti P, Remuzzi G. Sirolimus for calcineurin inhibitors in organ transplantation: contra. Kidney Int. 2010;78:1068-1074.
5. van Gelder T, ter Meulen CG, Henè R, Weimar W, Hoitsma A. Oral ulcers in kidney transplant recipients treated with sirolimus and mycophenolate mofetil. Transplantation. 2003;75: 788-791.
6. Stallone G, Infante B, Schena A, et al. Rapamycin for treatment of chronic allograft nephropathy in renal transplant patients. J Am Soc Nephrol. 2005;16:3755-3762.
7. Watson CJE, Firth J, Williams PF, et al. A randomized controlled trial of late conversion from CNI-based to sirolimusbased immunosuppression following renal transplantation. Am J Transplant. 2005;5:2496-2503.
8. Schena FP, Pascoe MD, Alberu J, et al. Conversion from calcineurin inhibitors to sirolimus maintenance therapy in renal allograft recipients: 24-month efficacy and safety results from the CONVERT Trial. Transplantation. 2008;87:233-242.
9. Mulay AV, Cockfield S, Stryker R, Fergusson D, Knoll GA. Conversion from calcineurin inhibitors to sirolimus for chronic renal allograft dysfunction: a systematic review of the evidence. Transplantation. 2006;82:1153-1162.
10. Liptak P, Ivanyi B. Primer: histopathology of calcineurin-inhibitor toxicity in renal allograft. Nat Clin Pract Nephrol. 2006;2: 398-404.
11. Ruiz JC, Campistol JM, Grinyo JM, et al. Early cyclosporine A withdrawal in kidney-transplant recipients receiving sirolimus prevents progression of chronic pathologic allograft lesions. Transplantation. 2004;78:1312-1318.
12. Oberbauer R, Segoloni G, Campistol JM, et al. Early cyclosporine withdrawal from a sirolimus-based regimen results in better renal allograft survival and renal function at 48 months after transplantation. Transplant Int. 2005;18:22-28.
13. Paoletti E, Amidone M, Cassottana P, Gherzi M, Marsano L, Cannella G. Effect of sirolimus on left ventricular hypertrophy in kidney transplant recipients: a 1-year nonrandomized controlled trial. Am J Kidney Dis. 2008;52:324-330.
14. National Kidney Foundation. K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis. 2004;43(Suppl 1):S1-S290.
15. Devereux RB, Alonso DR, Lutas EM, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necroscopy findings. Am J Cardiol. 1986;57:450-458.
16. Zoccali C, Benedetto FA, Mallamaci F, et al. Prognostic impact of the indexation of left ventricular mass in patients undergoing dialysis. J Am Soc Nephrol. 2001;12:2768-2774.
17. Ferrara LA, Vaccaro O, Cardoni O, et al. Indexation criteria of left ventricular mass and predictive role of blood pressure and body composition. Am J Hypertens. 2005;18: 1263-1265.
18. Levey AS, Greene T, Kusek JW, et al. A simplified equation to predict glomerular filtration rate from serum creatinine [abstract]. J Am Soc Nephrol. 2000;11:A0828.
19. Desai N, Heenan S, Mortimer PS. Sirolimus-associated lymphoedema: eight new cases and a proposed mechanism. Br J Dermatol. 2009;160:1322-1326.
20. Schnuelle P, van der Heide JH, Tegzess A, et al. Open randomized trial comparing early withdrawal of either cyclosporine or mycophenolate mofetil in stable renal transplant recipients initially treated with a triple drug regimen. J Am Soc Nephrol. 2002;13:536-543.
21. Suwelack B, Gerhardt U, Hohage H. Withdrawal of cyclosporine or tacrolimus after addition of mycophenolate mofetil in patients with chronic allograft nephropathy. Am J Transplant. 2004;4:655-662.
22. Hernandez D, Lacalzada J, Salido E, et al. Regression of left ventricular hypertrophy by lisinopril after renal transplantation: role of ACE gene polymorphism. Kidney Int. 2000;58:889-897.
23. Midtvedt K, Ihlen H, Hartmann A, et al. Reduction of left ventricular mass by lisinopril and nifedipine in hypertensive renal transplant recipients: a prospective randomized doubleblind study. Transplantation. 2001;72:107-111.
24. Patel RK, Mark PB, Johnston N, Mc Gregor E, Dargie HJ, Jardine AG. Renal transplantation is not associated with regression of left ventricular hypertrophy: a magnetic resonance study. Clin J Am Soc Nephrol. 2008;3:1807-1811.
25. Raichlin E, Chandrasekaran K, Kremers WK, et al. Sirolimus as primary immunosuppressant reduces left ventricular mass and improves diastolic function of the cardiac allograft. Transplantation. 2008;86:1395-400.
26. Paoletti E, Bellino D, Gallina AM, Amidone M, Cassottana P, Cannella G. Is left ventricular hypertrophy a powerful predictor of progression to dialysis in chronic kidney disease? Nephrol Dial Transplant. 2011;26:670-677.
27. McMullen JR, Sherwood MC, Tarnavski O, et al. Inhibition of mTOR signaling with rapamycin regresses established cardiac hypertrophy induced by pressure overload. Circulation. 2004;109:3050-3055.
28. Siedlecki AM, Jin X, Muslin AJ. Uremic cardiac hypertrophy is reversed by rapamycin but not by lowering of blood pressure. Kidney Int. 2009;75:800-808.
29. Ekberg H, Tedesco-Silva H, Demirbas A, et al. Reduced exposure to calcineurin inhibitors in renal transplantation. N Engl J Med. 2007;357:2562-2575.
30. Wali RK, Mohanlal V, Ramos E, et al. Early withdrawal of calcineurin inhibitors and rescue immunosuppression with sirolimus-based therapy in renal transplant recipients with moderate to severe renal dysfunction. Am J Transplant. 2007;7:1572-1583.
31. Abramowicz D, Hadaya K, Hazzan M, et al. Conversion to sirolimus for chronic renal allograft dysfunction: risk factors for graft loss and severe side effects. Nephrol Dial Transplant. 2008;23:3727-3729.
32. Kreis H, Cisterne JM, Land W, et al. Sirolimus in association with mycophenolate mofetil induction for the prevention of acute graft rejection in renal allograft recipients. Transplantation. 2000;69:1252-1260.
33. Buchler M, Caillard S, Barbier S, et al. Sirolimus versus cyclosporine in kidney recipients receiving thymoglobulin, mycophenolate mofetil and a 6-month course of steroids. Am J Transplant. 2007;7:2522-2531.
34. Durrbach A, Rostaing L, Tricot L, et al. Prospective comparison of the use of sirolimus and cyclosporine in recipients of kidney from an expanded criteria donor. Transplantation. 2008;85:486-490.
35. Saurina A, Campistol JM, Piera C, et al. Conversion from calcineurin inhibitors to sirolimus in chronic allograftdysfunction: changes in glomerular haemodynamics and proteinuria. Nephrol Dial Transplant. 2006;21:488-493.
36. Servais A, Meas-Yedid V, Toupance O, et al. Interstitial fibrosis quantification in renal transplant recipients randomized to continue cyclosporine or convert to sirolimus. Am J Transplant. 2009;9:2552-2560.
37. Cai Y, Chen Y, Zheng S, Chen B, Yang Y, Xia P. Sirolimus damages podocytes in rats with protein overload nephropathy. J Nephrol. 2011;24:307-312.