Rapamycin in patients with chronic renal allograft dysfunction

Mai Szu Wu, Chiz Tzung Chang, Cheng Chieh Hung

研究成果: 雜誌貢獻文章

17 引文 (Scopus)

摘要

Purpose: Nephrotoxicity of calcineurin inhibitors (CNI) complicates the management of chronic renal allograft dysfunction. Rapamycin is a promising immunosuppressive agent free of nephrotoxicity. The effect of conversion from CNI to rapamycin in recipients with chronic allograft dysfunction is still unclear. We investigated the effect of rapamycin in patients with chronic allograft dysfunction. Methods: We conducted a prospective study on kidney transplant recipients with chronic allograft dysfunction. The patients were under classic CNI, mycophenolate mofetil, and prednisolone triple therapy. They had progressive deterioration of the allograft function. They were converted from CNI to rapamycin directly and observed for 6 months. The CNI serum levels before the conversion were within recommended range. Allograft function, clinical features and adverse effects were evaluated before and after the rapamycin conversion. Results: A total of 16 patients were enrolled. Six of them (37.5%) failed to have a smooth conversion because of deterioration of allograft function and intractable adverse effects. Ten patients (62.5%) went through the 6-month observation period with improved graft function. The average reduction of serum creatinine was 27.7% (p <0.001) in successful conversion. There were no significant differences on age, gender, lipid profile, sugar control, and rapamycin levels between successful and failed conversion. Anemia and diastolic blood pressure were significantly improved after successful conversion. The failed patients had a longer transplantation period (6.1 ± 4.1 vs. 11.2 ± 3.4 yr, p <0.05). Two of them (12.5%) developed bacteria pneumonia. Self-limited diarrhea developed in three patients (18.8%). Conclusion: We suggested that conversion from CNI to rapamycin was beneficial in some kidney transplant recipients with chronic allograft dysfunction.

原文英語
頁(從 - 到)236-242
頁數7
期刊Clinical Transplantation
19
發行號2
DOIs
出版狀態已發佈 - 四月 2005
對外發佈Yes

指紋

Sirolimus
Allografts
Kidney
Mycophenolic Acid
Blood Pressure
Immunosuppressive Agents
Prednisolone
Serum
Calcineurin Inhibitors
Anemia
Diarrhea
Creatinine
Pneumonia
Transplantation
Observation
Prospective Studies
Bacteria
Transplants
Lipids

ASJC Scopus subject areas

  • Transplantation
  • Immunology

引用此文

Rapamycin in patients with chronic renal allograft dysfunction. / Wu, Mai Szu; Chang, Chiz Tzung; Hung, Cheng Chieh.

於: Clinical Transplantation, 卷 19, 編號 2, 04.2005, p. 236-242.

研究成果: 雜誌貢獻文章

Wu, Mai Szu ; Chang, Chiz Tzung ; Hung, Cheng Chieh. / Rapamycin in patients with chronic renal allograft dysfunction. 於: Clinical Transplantation. 2005 ; 卷 19, 編號 2. 頁 236-242.
@article{a66bc07f73ee4e24a1c21b58b22bc971,
title = "Rapamycin in patients with chronic renal allograft dysfunction",
abstract = "Purpose: Nephrotoxicity of calcineurin inhibitors (CNI) complicates the management of chronic renal allograft dysfunction. Rapamycin is a promising immunosuppressive agent free of nephrotoxicity. The effect of conversion from CNI to rapamycin in recipients with chronic allograft dysfunction is still unclear. We investigated the effect of rapamycin in patients with chronic allograft dysfunction. Methods: We conducted a prospective study on kidney transplant recipients with chronic allograft dysfunction. The patients were under classic CNI, mycophenolate mofetil, and prednisolone triple therapy. They had progressive deterioration of the allograft function. They were converted from CNI to rapamycin directly and observed for 6 months. The CNI serum levels before the conversion were within recommended range. Allograft function, clinical features and adverse effects were evaluated before and after the rapamycin conversion. Results: A total of 16 patients were enrolled. Six of them (37.5{\%}) failed to have a smooth conversion because of deterioration of allograft function and intractable adverse effects. Ten patients (62.5{\%}) went through the 6-month observation period with improved graft function. The average reduction of serum creatinine was 27.7{\%} (p <0.001) in successful conversion. There were no significant differences on age, gender, lipid profile, sugar control, and rapamycin levels between successful and failed conversion. Anemia and diastolic blood pressure were significantly improved after successful conversion. The failed patients had a longer transplantation period (6.1 ± 4.1 vs. 11.2 ± 3.4 yr, p <0.05). Two of them (12.5{\%}) developed bacteria pneumonia. Self-limited diarrhea developed in three patients (18.8{\%}). Conclusion: We suggested that conversion from CNI to rapamycin was beneficial in some kidney transplant recipients with chronic allograft dysfunction.",
keywords = "Calcineurin inhibitors, Chronic allograft dysfunction, Rapamycin",
author = "Wu, {Mai Szu} and Chang, {Chiz Tzung} and Hung, {Cheng Chieh}",
year = "2005",
month = "4",
doi = "10.1111/j.1399-0012.2005.00329.x",
language = "English",
volume = "19",
pages = "236--242",
journal = "Clinical Transplantation",
issn = "0902-0063",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Rapamycin in patients with chronic renal allograft dysfunction

AU - Wu, Mai Szu

AU - Chang, Chiz Tzung

AU - Hung, Cheng Chieh

PY - 2005/4

Y1 - 2005/4

N2 - Purpose: Nephrotoxicity of calcineurin inhibitors (CNI) complicates the management of chronic renal allograft dysfunction. Rapamycin is a promising immunosuppressive agent free of nephrotoxicity. The effect of conversion from CNI to rapamycin in recipients with chronic allograft dysfunction is still unclear. We investigated the effect of rapamycin in patients with chronic allograft dysfunction. Methods: We conducted a prospective study on kidney transplant recipients with chronic allograft dysfunction. The patients were under classic CNI, mycophenolate mofetil, and prednisolone triple therapy. They had progressive deterioration of the allograft function. They were converted from CNI to rapamycin directly and observed for 6 months. The CNI serum levels before the conversion were within recommended range. Allograft function, clinical features and adverse effects were evaluated before and after the rapamycin conversion. Results: A total of 16 patients were enrolled. Six of them (37.5%) failed to have a smooth conversion because of deterioration of allograft function and intractable adverse effects. Ten patients (62.5%) went through the 6-month observation period with improved graft function. The average reduction of serum creatinine was 27.7% (p <0.001) in successful conversion. There were no significant differences on age, gender, lipid profile, sugar control, and rapamycin levels between successful and failed conversion. Anemia and diastolic blood pressure were significantly improved after successful conversion. The failed patients had a longer transplantation period (6.1 ± 4.1 vs. 11.2 ± 3.4 yr, p <0.05). Two of them (12.5%) developed bacteria pneumonia. Self-limited diarrhea developed in three patients (18.8%). Conclusion: We suggested that conversion from CNI to rapamycin was beneficial in some kidney transplant recipients with chronic allograft dysfunction.

AB - Purpose: Nephrotoxicity of calcineurin inhibitors (CNI) complicates the management of chronic renal allograft dysfunction. Rapamycin is a promising immunosuppressive agent free of nephrotoxicity. The effect of conversion from CNI to rapamycin in recipients with chronic allograft dysfunction is still unclear. We investigated the effect of rapamycin in patients with chronic allograft dysfunction. Methods: We conducted a prospective study on kidney transplant recipients with chronic allograft dysfunction. The patients were under classic CNI, mycophenolate mofetil, and prednisolone triple therapy. They had progressive deterioration of the allograft function. They were converted from CNI to rapamycin directly and observed for 6 months. The CNI serum levels before the conversion were within recommended range. Allograft function, clinical features and adverse effects were evaluated before and after the rapamycin conversion. Results: A total of 16 patients were enrolled. Six of them (37.5%) failed to have a smooth conversion because of deterioration of allograft function and intractable adverse effects. Ten patients (62.5%) went through the 6-month observation period with improved graft function. The average reduction of serum creatinine was 27.7% (p <0.001) in successful conversion. There were no significant differences on age, gender, lipid profile, sugar control, and rapamycin levels between successful and failed conversion. Anemia and diastolic blood pressure were significantly improved after successful conversion. The failed patients had a longer transplantation period (6.1 ± 4.1 vs. 11.2 ± 3.4 yr, p <0.05). Two of them (12.5%) developed bacteria pneumonia. Self-limited diarrhea developed in three patients (18.8%). Conclusion: We suggested that conversion from CNI to rapamycin was beneficial in some kidney transplant recipients with chronic allograft dysfunction.

KW - Calcineurin inhibitors

KW - Chronic allograft dysfunction

KW - Rapamycin

UR - http://www.scopus.com/inward/record.url?scp=15844418962&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=15844418962&partnerID=8YFLogxK

U2 - 10.1111/j.1399-0012.2005.00329.x

DO - 10.1111/j.1399-0012.2005.00329.x

M3 - Article

C2 - 15740561

AN - SCOPUS:15844418962

VL - 19

SP - 236

EP - 242

JO - Clinical Transplantation

JF - Clinical Transplantation

SN - 0902-0063

IS - 2

ER -