Document Detail


A comparison of the effects of C2-cyclosporine and C0-tacrolimus on renal function and cardiovascular risk factors in kidney transplant recipients.
MedLine Citation:
PMID:  17038908     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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
Related Documents :
16581328 - Statin safety: lessons from new drug applications for marketed statins.
8059728 - Incidence of myocarditis in peripartum cardiomyopathy.
15539108 - Lessons learned from recent clinical trials in hypertensive diabetics: what's good for ...
12091628 - European best practice guidelines for renal transplantation. section iv: long-term mana...
16842528 - Comparative outcomes of reduced intensity and myeloablative allogeneic hematopoietic st...
16939478 - Current and future pharmacotherapies of premature ejaculation.
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation     Volume:  82     ISSN:  0041-1337     ISO Abbreviation:  Transplantation     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-13     Completed Date:  2006-11-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  924-30     Citation Subset:  IM    
Affiliation:
Division of Nephrology, University of Toronto, Toronto, Ontario, Canada.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
0/Immunosuppressive Agents; 109581-93-3/Tacrolimus; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Impaired arterial compliance and aerobic endurance in kidney transplant recipients.
Next Document:  Curcumin has potent liver preservation properties in an isolated perfusion model.