Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function

Detalhes bibliográficos
Autor(a) principal: Silva,L.A.
Data de Publicação: 2006
Outros Autores: Felipe,C.R., Park,S.I., Pinheiro-Machado,P., Garcia,R., Franco,M., Moreira,S.R., Tedesco-Silva Jr.,H., Medina-Pestana,J.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Medical and Biological Research
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2006000100005
Resumo: We conducted a retrospective analysis of the influence of full doses of calcineurin inhibitors [8-10 mg kg-1 day-1 cyclosporine (N = 80), or 0.2-0.3 mg kg-1 day-1 tacrolimus (N = 68)] administered from day 1 after transplantation on the transplant outcomes of a high-risk population. Induction therapy was used in 13% of the patients. Patients also received azathioprine (2 mg kg-1 day-1, N = 58) or mycophenolate mofetil (2 g/day, N = 90), and prednisone (0.5 mg kg-1 day-1, N = 148). Mean time on dialysis was 79 ± 41 months, 12% of the cases were re-transplants, and 21% had panel reactive antibodies >10%. In 43% of donors the cause of death was cerebrovascular disease and 27% showed creatinine above 1.5 mg/dL. The incidence of slow graft function (SGF) and delayed graft function (DGF) was 15 and 60%, respectively. Mean time to last dialysis and to nadir creatinine were 18 ± 15 and 34 ± 20 days, respectively. Mean creatinine at 1 year after transplantation was 1.48 ± 0.50 mg/dL (DGF 1.68 ± 0.65 vs SGF 1.67 ± 0.66 vs immediate graft function (IGF) 1.41 ± 0.40 mg/dL, P = 0.089). The incidence of biopsy-confirmed acute rejection was 22% (DGF 31%, SGF 10%, IGF 8%). One-year patient and graft survival was 92.6 and 78.4%, respectively. The incidence of cytomegalovirus disease, post-transplant diabetes mellitus and malignancies was 28, 8.1, and 0%, respectively. Compared to previous studies, the use of initial full doses of calcineurin inhibitors without antibody induction in patients with SGF or DGF had no negative impact on patient and graft survival.
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spelling Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft functionCyclosporineTacrolimusDelayed graft functionGraft functionKidney transplantationWe conducted a retrospective analysis of the influence of full doses of calcineurin inhibitors [8-10 mg kg-1 day-1 cyclosporine (N = 80), or 0.2-0.3 mg kg-1 day-1 tacrolimus (N = 68)] administered from day 1 after transplantation on the transplant outcomes of a high-risk population. Induction therapy was used in 13% of the patients. Patients also received azathioprine (2 mg kg-1 day-1, N = 58) or mycophenolate mofetil (2 g/day, N = 90), and prednisone (0.5 mg kg-1 day-1, N = 148). Mean time on dialysis was 79 ± 41 months, 12% of the cases were re-transplants, and 21% had panel reactive antibodies >10%. In 43% of donors the cause of death was cerebrovascular disease and 27% showed creatinine above 1.5 mg/dL. The incidence of slow graft function (SGF) and delayed graft function (DGF) was 15 and 60%, respectively. Mean time to last dialysis and to nadir creatinine were 18 ± 15 and 34 ± 20 days, respectively. Mean creatinine at 1 year after transplantation was 1.48 ± 0.50 mg/dL (DGF 1.68 ± 0.65 vs SGF 1.67 ± 0.66 vs immediate graft function (IGF) 1.41 ± 0.40 mg/dL, P = 0.089). The incidence of biopsy-confirmed acute rejection was 22% (DGF 31%, SGF 10%, IGF 8%). One-year patient and graft survival was 92.6 and 78.4%, respectively. The incidence of cytomegalovirus disease, post-transplant diabetes mellitus and malignancies was 28, 8.1, and 0%, respectively. Compared to previous studies, the use of initial full doses of calcineurin inhibitors without antibody induction in patients with SGF or DGF had no negative impact on patient and graft survival.Associação Brasileira de Divulgação Científica2006-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2006000100005Brazilian Journal of Medical and Biological Research v.39 n.1 2006reponame:Brazilian Journal of Medical and Biological Researchinstname:Associação Brasileira de Divulgação Científica (ABDC)instacron:ABDC10.1590/S0100-879X2006000100005info:eu-repo/semantics/openAccessSilva,L.A.Felipe,C.R.Park,S.I.Pinheiro-Machado,P.Garcia,R.Franco,M.Moreira,S.R.Tedesco-Silva Jr.,H.Medina-Pestana,J.eng2005-12-15T00:00:00Zoai:scielo:S0100-879X2006000100005Revistahttps://www.bjournal.org/https://old.scielo.br/oai/scielo-oai.phpbjournal@terra.com.br||bjournal@terra.com.br1414-431X0100-879Xopendoar:2005-12-15T00:00Brazilian Journal of Medical and Biological Research - Associação Brasileira de Divulgação Científica (ABDC)false
dc.title.none.fl_str_mv Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function
title Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function
spellingShingle Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function
Silva,L.A.
Cyclosporine
Tacrolimus
Delayed graft function
Graft function
Kidney transplantation
title_short Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function
title_full Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function
title_fullStr Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function
title_full_unstemmed Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function
title_sort Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function
author Silva,L.A.
author_facet Silva,L.A.
Felipe,C.R.
Park,S.I.
Pinheiro-Machado,P.
Garcia,R.
Franco,M.
Moreira,S.R.
Tedesco-Silva Jr.,H.
Medina-Pestana,J.
author_role author
author2 Felipe,C.R.
Park,S.I.
Pinheiro-Machado,P.
Garcia,R.
Franco,M.
Moreira,S.R.
Tedesco-Silva Jr.,H.
Medina-Pestana,J.
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Silva,L.A.
Felipe,C.R.
Park,S.I.
Pinheiro-Machado,P.
Garcia,R.
Franco,M.
Moreira,S.R.
Tedesco-Silva Jr.,H.
Medina-Pestana,J.
dc.subject.por.fl_str_mv Cyclosporine
Tacrolimus
Delayed graft function
Graft function
Kidney transplantation
topic Cyclosporine
Tacrolimus
Delayed graft function
Graft function
Kidney transplantation
description We conducted a retrospective analysis of the influence of full doses of calcineurin inhibitors [8-10 mg kg-1 day-1 cyclosporine (N = 80), or 0.2-0.3 mg kg-1 day-1 tacrolimus (N = 68)] administered from day 1 after transplantation on the transplant outcomes of a high-risk population. Induction therapy was used in 13% of the patients. Patients also received azathioprine (2 mg kg-1 day-1, N = 58) or mycophenolate mofetil (2 g/day, N = 90), and prednisone (0.5 mg kg-1 day-1, N = 148). Mean time on dialysis was 79 ± 41 months, 12% of the cases were re-transplants, and 21% had panel reactive antibodies >10%. In 43% of donors the cause of death was cerebrovascular disease and 27% showed creatinine above 1.5 mg/dL. The incidence of slow graft function (SGF) and delayed graft function (DGF) was 15 and 60%, respectively. Mean time to last dialysis and to nadir creatinine were 18 ± 15 and 34 ± 20 days, respectively. Mean creatinine at 1 year after transplantation was 1.48 ± 0.50 mg/dL (DGF 1.68 ± 0.65 vs SGF 1.67 ± 0.66 vs immediate graft function (IGF) 1.41 ± 0.40 mg/dL, P = 0.089). The incidence of biopsy-confirmed acute rejection was 22% (DGF 31%, SGF 10%, IGF 8%). One-year patient and graft survival was 92.6 and 78.4%, respectively. The incidence of cytomegalovirus disease, post-transplant diabetes mellitus and malignancies was 28, 8.1, and 0%, respectively. Compared to previous studies, the use of initial full doses of calcineurin inhibitors without antibody induction in patients with SGF or DGF had no negative impact on patient and graft survival.
publishDate 2006
dc.date.none.fl_str_mv 2006-01-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2006000100005
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0100-879X2006000100005
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S0100-879X2006000100005
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Associação Brasileira de Divulgação Científica
publisher.none.fl_str_mv Associação Brasileira de Divulgação Científica
dc.source.none.fl_str_mv Brazilian Journal of Medical and Biological Research v.39 n.1 2006
reponame:Brazilian Journal of Medical and Biological Research
instname:Associação Brasileira de Divulgação Científica (ABDC)
instacron:ABDC
instname_str Associação Brasileira de Divulgação Científica (ABDC)
instacron_str ABDC
institution ABDC
reponame_str Brazilian Journal of Medical and Biological Research
collection Brazilian Journal of Medical and Biological Research
repository.name.fl_str_mv Brazilian Journal of Medical and Biological Research - Associação Brasileira de Divulgação Científica (ABDC)
repository.mail.fl_str_mv bjournal@terra.com.br||bjournal@terra.com.br
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