Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy
Autor(a) principal: | |
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Data de Publicação: | 2009 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/5013 http://dx.doi.org/10.1590/S0100-879X2009000500008 |
Resumo: | Experimental data and few clinical non-randomized studies have shown that inhibition of the renin-angiotensin system by angiotensin-converting enzyme (ACE) associated or not with the use of mycophenolate mofetil (MMF) could delay or even halt the progression of chronic allograft nephropathy (CAN). In this retrospective historical study, we investigated whether ACE inhibition (ACEI) associated or not with the use of MMF has the same effect in humans as in experimental studies and what factors are associated with a clinical response. A total of 160 transplant patients with biopsy-proven CAN were enrolled. Eighty-one of them were on ACE therapy (G1) and 80 on ACEI_free therapy (G2). Patients were further stratified for the use of MMF. G1 patients showed a marked decrease in proteinuria and stabilized serum creatinine with time. Five-year graft survival after CAN diagnosis was more frequent in G1 (86.9 vs 67.7%; P < 0.05). In patients on ACEI-free therapy, the use of MMF was associated with better graft survival. The use of ACEI therapy protected 79% of the patients against graft loss (OR = 0.079, 95%CI = 0.015-0.426; P = 0.003). ACEI and MMF or the use of MMF alone after CAN diagnosis conferred protection against graft loss. This finding is well correlated with experimental studies in which ACEI and MMF interrupt the progression of chronic allograft dysfunction and injury. The use of ACEI alone or in combination with MMF significantly reduced proteinuria and stabilized serum creatinine, consequently improving renal allograft survival. |
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Moscoso-Solorzano, G.t. [UNIFESP]Mastroianni Kirsztajn, Gianna [UNIFESP]Ozaki, K.s. [UNIFESP]Franco, Marcello Fabiano de [UNIFESP]Pacheco-Silva, Alvaro [UNIFESP]Câmara, Niels Olsen Saraiva [UNIFESP]Universidade Federal de São Paulo (UNIFESP)Universidade de São Paulo (USP)2015-06-14T13:39:11Z2015-06-14T13:39:11Z2009-05-01Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 42, n. 5, p. 445-452, 2009.0100-879Xhttp://repositorio.unifesp.br/handle/11600/5013http://dx.doi.org/10.1590/S0100-879X2009000500008S0100-879X2009000500008.pdfS0100-879X200900050000810.1590/S0100-879X2009000500008WOS:000265286600008Experimental data and few clinical non-randomized studies have shown that inhibition of the renin-angiotensin system by angiotensin-converting enzyme (ACE) associated or not with the use of mycophenolate mofetil (MMF) could delay or even halt the progression of chronic allograft nephropathy (CAN). In this retrospective historical study, we investigated whether ACE inhibition (ACEI) associated or not with the use of MMF has the same effect in humans as in experimental studies and what factors are associated with a clinical response. A total of 160 transplant patients with biopsy-proven CAN were enrolled. Eighty-one of them were on ACE therapy (G1) and 80 on ACEI_free therapy (G2). Patients were further stratified for the use of MMF. G1 patients showed a marked decrease in proteinuria and stabilized serum creatinine with time. Five-year graft survival after CAN diagnosis was more frequent in G1 (86.9 vs 67.7%; P < 0.05). In patients on ACEI-free therapy, the use of MMF was associated with better graft survival. The use of ACEI therapy protected 79% of the patients against graft loss (OR = 0.079, 95%CI = 0.015-0.426; P = 0.003). ACEI and MMF or the use of MMF alone after CAN diagnosis conferred protection against graft loss. This finding is well correlated with experimental studies in which ACEI and MMF interrupt the progression of chronic allograft dysfunction and injury. The use of ACEI alone or in combination with MMF significantly reduced proteinuria and stabilized serum creatinine, consequently improving renal allograft survival.Universidade Federal de São Paulo (UNIFESP) Hospital do Rim e Hipertensão Disciplina de NefrologiaUniversidade Federal de São Paulo (UNIFESP) Departamento de PatologiaUniversidade de São Paulo Instituto de Ciências Biomédicas IV Departamento de ImunologiaUNIFESP, Hospital do Rim e Hipertensão Disciplina de NefrologiaUNIFESP, Depto. de PatologiaSciELO445-452engAssociação Brasileira de Divulgação CientíficaBrazilian Journal of Medical and Biological ResearchRenin-angiotensin systemMycophenolate mofetilRenal allograft survivalKidney transplantationSynergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALS0100-879X2009000500008.pdfapplication/pdf107483${dspace.ui.url}/bitstream/11600/5013/1/S0100-879X2009000500008.pdfdc593ceb786c6a44bfc4132542eff2d7MD51open accessTEXTS0100-879X2009000500008.pdf.txtS0100-879X2009000500008.pdf.txtExtracted texttext/plain35520${dspace.ui.url}/bitstream/11600/5013/2/S0100-879X2009000500008.pdf.txt599197a0c7344e007e7b30a2a8785b77MD52open access11600/50132021-10-05 21:50:01.171open accessoai:repositorio.unifesp.br:11600/5013Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:09:47.887388Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy |
title |
Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy |
spellingShingle |
Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy Moscoso-Solorzano, G.t. [UNIFESP] Renin-angiotensin system Mycophenolate mofetil Renal allograft survival Kidney transplantation |
title_short |
Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy |
title_full |
Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy |
title_fullStr |
Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy |
title_full_unstemmed |
Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy |
title_sort |
Synergistic effect of mycophenolate mofetil and angiotensin-converting enzyme inhibitor in patients with chronic allograft nephropathy |
author |
Moscoso-Solorzano, G.t. [UNIFESP] |
author_facet |
Moscoso-Solorzano, G.t. [UNIFESP] Mastroianni Kirsztajn, Gianna [UNIFESP] Ozaki, K.s. [UNIFESP] Franco, Marcello Fabiano de [UNIFESP] Pacheco-Silva, Alvaro [UNIFESP] Câmara, Niels Olsen Saraiva [UNIFESP] |
author_role |
author |
author2 |
Mastroianni Kirsztajn, Gianna [UNIFESP] Ozaki, K.s. [UNIFESP] Franco, Marcello Fabiano de [UNIFESP] Pacheco-Silva, Alvaro [UNIFESP] Câmara, Niels Olsen Saraiva [UNIFESP] |
author2_role |
author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Universidade de São Paulo (USP) |
dc.contributor.author.fl_str_mv |
Moscoso-Solorzano, G.t. [UNIFESP] Mastroianni Kirsztajn, Gianna [UNIFESP] Ozaki, K.s. [UNIFESP] Franco, Marcello Fabiano de [UNIFESP] Pacheco-Silva, Alvaro [UNIFESP] Câmara, Niels Olsen Saraiva [UNIFESP] |
dc.subject.eng.fl_str_mv |
Renin-angiotensin system Mycophenolate mofetil Renal allograft survival Kidney transplantation |
topic |
Renin-angiotensin system Mycophenolate mofetil Renal allograft survival Kidney transplantation |
description |
Experimental data and few clinical non-randomized studies have shown that inhibition of the renin-angiotensin system by angiotensin-converting enzyme (ACE) associated or not with the use of mycophenolate mofetil (MMF) could delay or even halt the progression of chronic allograft nephropathy (CAN). In this retrospective historical study, we investigated whether ACE inhibition (ACEI) associated or not with the use of MMF has the same effect in humans as in experimental studies and what factors are associated with a clinical response. A total of 160 transplant patients with biopsy-proven CAN were enrolled. Eighty-one of them were on ACE therapy (G1) and 80 on ACEI_free therapy (G2). Patients were further stratified for the use of MMF. G1 patients showed a marked decrease in proteinuria and stabilized serum creatinine with time. Five-year graft survival after CAN diagnosis was more frequent in G1 (86.9 vs 67.7%; P < 0.05). In patients on ACEI-free therapy, the use of MMF was associated with better graft survival. The use of ACEI therapy protected 79% of the patients against graft loss (OR = 0.079, 95%CI = 0.015-0.426; P = 0.003). ACEI and MMF or the use of MMF alone after CAN diagnosis conferred protection against graft loss. This finding is well correlated with experimental studies in which ACEI and MMF interrupt the progression of chronic allograft dysfunction and injury. The use of ACEI alone or in combination with MMF significantly reduced proteinuria and stabilized serum creatinine, consequently improving renal allograft survival. |
publishDate |
2009 |
dc.date.issued.fl_str_mv |
2009-05-01 |
dc.date.accessioned.fl_str_mv |
2015-06-14T13:39:11Z |
dc.date.available.fl_str_mv |
2015-06-14T13:39:11Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
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article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 42, n. 5, p. 445-452, 2009. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/5013 http://dx.doi.org/10.1590/S0100-879X2009000500008 |
dc.identifier.issn.none.fl_str_mv |
0100-879X |
dc.identifier.file.none.fl_str_mv |
S0100-879X2009000500008.pdf |
dc.identifier.scielo.none.fl_str_mv |
S0100-879X2009000500008 |
dc.identifier.doi.none.fl_str_mv |
10.1590/S0100-879X2009000500008 |
dc.identifier.wos.none.fl_str_mv |
WOS:000265286600008 |
identifier_str_mv |
Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 42, n. 5, p. 445-452, 2009. 0100-879X S0100-879X2009000500008.pdf S0100-879X2009000500008 10.1590/S0100-879X2009000500008 WOS:000265286600008 |
url |
http://repositorio.unifesp.br/handle/11600/5013 http://dx.doi.org/10.1590/S0100-879X2009000500008 |
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eng |
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Brazilian Journal of Medical and Biological Research |
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info:eu-repo/semantics/openAccess |
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Associação Brasileira de Divulgação Científica |
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Associação Brasileira de Divulgação Científica |
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