PMID- 21094806
OWN - NLM
STAT- MEDLINE
DCOM- 20110307
LR  - 20211203
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 42
IP  - 9
DP  - 2010 Nov
TI  - Low-dose calcineurin inhibitor regimen combined with mammalian target of 
      rapamycin inhibitors preserves kidney functions in renal transplant recipients 
      without allograft nephropathy.
PG  - 3513-6
LID - 10.1016/j.transproceed.2010.08.043 [doi]
AB  - OBJECTIVE: The present study was designed to investigate the effect of low-dose 
      calcineurin inhibitor (CNI) tacrolimus combined with a mammalian target of 
      rapamycin (mTOR) inhibitor on renal function in transplant recipients without 
      allograft nephropathy. PATIENTS AND METHODS: Twelve patients including seven men 
      (58.3%) of overall mean age of 34.8 +/- 14.1 years underwent renal transplantation 
      and were switched to a new second-line treatment of low-dose CNI combined with an 
      mTOR inhibitor, either sirolimus or everolimus. RESULTS: The underlying cause of 
      renal failure was not clear in half of the cases; for the others it was chronic 
      glomerulonephritis, diabetic nephropathy, polycystic kidney disease, or 
      hypovolemia. After 6 months of the new therapy, there was a significant increase 
      in calculated creatinine clearance levels compared to baseline (75.5 +/- 21.9 vs 
      89.6 +/- 19.1 mL/min; P < .001), but no significant change in serum creatinine (1.3 
      +/- 0.4 vs 1.2 +/- 0.3 mg/dL) or urinary protein excretion (187.5 +/- 142.0 vs 394.0 +/- 
      326.4 mg/g). For almost all patients, proteinuria remained stable, but in two 
      patients, it developed but responded to enalapril treatment. Dose decrement was 
      required for four patients with hyperlipidemia (50%); one patient experienced 
      new-onset hyperlipidemia that responded to treatment. One patient developed a 
      urinary tract infection that responded to antibiotic treatment. None of the 
      patients developed an acute rejection episode. CONCLUSION: Low-dose CNI combined 
      with an mTOR inhibitor, as a replacement for mycophenolate mofetil or 
      enteric-coated mycophenolate sodium, seemed to prevent renal dysfunction for at 
      least 6 months among renal transplant patients without allograft nephropathy.
CI  - Copyright (c) 2010. Published by Elsevier Inc.
FAU - Kacar, S
AU  - Kacar S
AD  - Kent Hospital, Izmir, Turkey. hilmiserdar@superonline.com
FAU - Gurkan, A
AU  - Gurkan A
FAU - Karaca, C
AU  - Karaca C
FAU - Varilsuha, C
AU  - Varilsuha C
FAU - Tilif, S
AU  - Tilif S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Biomarkers)
RN  - 0 (Calcineurin Inhibitors)
RN  - 0 (Immunosuppressive Agents)
RN  - 9HW64Q8G6G (Everolimus)
RN  - AYI8EX34EU (Creatinine)
RN  - EC 2.7.1.1 (MTOR protein, human)
RN  - EC 2.7.11.1 (TOR Serine-Threonine Kinases)
RN  - W36ZG6FT64 (Sirolimus)
RN  - WM0HAQ4WNM (Tacrolimus)
SB  - IM
MH  - Adult
MH  - Biomarkers/blood
MH  - *Calcineurin Inhibitors
MH  - Creatinine/blood
MH  - Drug Substitution
MH  - Drug Therapy, Combination
MH  - Everolimus
MH  - Female
MH  - Humans
MH  - Hyperlipidemias/etiology
MH  - Immunosuppressive Agents/*administration & dosage/adverse effects
MH  - Kidney/*drug effects/metabolism/physiopathology
MH  - *Kidney Transplantation/adverse effects
MH  - Male
MH  - Middle Aged
MH  - Proteinuria/etiology
MH  - Sirolimus/administration & dosage/adverse effects/*analogs & derivatives
MH  - TOR Serine-Threonine Kinases/*antagonists & inhibitors
MH  - Tacrolimus/*administration & dosage/adverse effects
MH  - Time Factors
MH  - Transplantation, Homologous
MH  - Treatment Outcome
MH  - Turkey
MH  - Urinary Tract Infections/etiology
MH  - Young Adult
EDAT- 2010/11/26 06:00
MHDA- 2011/03/08 06:00
CRDT- 2010/11/25 06:00
PHST- 2010/03/22 00:00 [received]
PHST- 2010/06/04 00:00 [revised]
PHST- 2010/08/26 00:00 [accepted]
PHST- 2010/11/25 06:00 [entrez]
PHST- 2010/11/26 06:00 [pubmed]
PHST- 2011/03/08 06:00 [medline]
AID - S0041-1345(10)01270-4 [pii]
AID - 10.1016/j.transproceed.2010.08.043 [doi]
PST - ppublish
SO  - Transplant Proc. 2010 Nov;42(9):3513-6. doi: 10.1016/j.transproceed.2010.08.043.