| A comparison of the effects of C2-cyclosporine and C0-tacrolimus on renal function and cardiovascular risk factors in kidney transplant recipients. | |
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MedLine Citation:
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PMID: 17038908 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: There are few data directly comparing the effects of two-hour postingestion monitored cyclosporine (C2-CsA) vs. trough-monitored tacrolimus (C0-Tac) on renal function and cardiovascular risk factors. METHODS: We studied 378 (202 C2-CsA vs. 176 C0-Tac) incident kidney transplant recipients in Toronto, Canada, from August 1, 2000 and December 31, 2003. Outcomes included changes in estimated glomerular filtration rate (eGFR at 1 and 6 months by modification of diet in renal disease four-variable equation), mean arterial pressure (MAP), total cholesterol (TC), and new-onset diabetes mellitus (NODM) at six months posttransplant. The independent effect of treatment/monitoring strategies on continuous outcomes and time-to-NODM was modeled using linear and Cox regression, respectively. RESULTS: Mean eGFR was 59.5 vs. 62.9 ml/min at one month and 50.6 vs. 61.2 ml/min at six months for C2-CsA vs. C0-Tac, respectively. Multiple linear regression revealed the slope of eGFR to be 0.93 ml/min/month lower in C2-CsA patients. This was equivalent to an adjusted average eGFR difference of 4.64 ml/min between months one and six posttransplant. There was no significant difference in average MAP and TC. In a stepwise multivariable Cox model and a propensity score analysis, there was no significant association between the type of treatment/monitoring strategy and time-to-NODM. CONCLUSIONS: There was a greater decline in eGFR for patients on C2-CsA (vs. C0-Tac) between one and six months posttransplant. However, MAP, TC, and the risk of NODM were comparable in both treatment/monitoring groups. The long-term impact of short-term reductions in eGFR as a function of the type of treatment/monitoring strategy requires further study. |
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Authors:
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S Joseph Kim; G V Ramesh Prasad; Michael Huang; Michelle M Nash; Olusegun Famure; Joseph Park; Mary Ann Thenganatt; Nizamuddin Chowdhury; Edward H Cole; Stanley S A Fenton; Daniel C Cattran; Jeffrey S Zaltzman; Carl J Cardella |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Transplantation Volume: 82 ISSN: 0041-1337 ISO Abbreviation: Transplantation Publication Date: 2006 Oct |
Date Detail:
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Created Date: 2006-10-13 Completed Date: 2006-11-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0132144 Medline TA: Transplantation Country: United States |
Other Details:
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Languages: eng Pagination: 924-30 Citation Subset: IM |
Affiliation:
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Division of Nephrology, University of Toronto, Toronto, Ontario, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Cardiovascular Diseases / epidemiology* Cyclosporine / adverse effects, therapeutic use* Female Glomerular Filtration Rate Humans Immunosuppressive Agents / adverse effects, therapeutic use Kidney Function Tests Kidney Transplantation / immunology, physiology* Male Patient Selection Postoperative Complications / epidemiology Risk Factors Tacrolimus / adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Immunosuppressive Agents; 109581-93-3/Tacrolimus; 59865-13-3/Cyclosporine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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