Calcineurin inhibitor sparing regimens using m-target of rapamycin inhibitors: an opportunity to improve cardiovascular risk following kidney transplantation?

Transplant International : Official Journal of the European Society for Organ Transplantation
Martin Zeier, Markus Van Der Giet

Abstract

Maintenance therapy with calcineurin inhibitors (CNIs) increases cardiovascular risk. Use of the m-TOR inhibitors everolimus or sirolimus to minimize CNI exposure is usually undertaken to preserve renal function following kidney transplantation, but may also improve cardiovascular risk status. Recent studies of early conversion from CNI to m-TOR inhibitors have shown a numerical improvement in the incidence of hypertension, but results are not clear-cut. Dyslipidaemia, in contrast, is more frequent under m-TORs than with CNI-based immunosuppression. New-onset diabetes is rare (≤ 5%) using modern m-TOR regimens, for example, everolimus and reduced-exposure CNI. Renal function improvement with m-TOR inhibitor regimens versus CNIs would also be expected to improve cardiovascular risk. Moreover, m-TOR-based CNI-minimization regimens are not associated with proteinuria, a known cardiovascular risk factor, with the possible exception of late conversion in patients with poor renal function. Interestingly, m-TOR inhibitors may also exert cardioprotective effects. Animal data suggest that m-TORs may restrict the pathogenesis of atherosclerosis, consistent with preliminary clinical data that conversion from CNIs to everolimus can stabili...Continue Reading

References

Aug 31, 1974·Lancet·C M HillM G McGeown
Feb 1, 1994·Journal of the American Society of Nephrology : JASN·M R FirstA Tejani
Jan 26, 1994·JAMA : the Journal of the American Medical Association·R C Mackow
Apr 1, 1997·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·R M JindalM L Milgrom
Nov 20, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·R N FoleyM J Sarnak
Mar 9, 2000·Transplantation·O ViklickýU Heemann
Mar 18, 2000·Kidney International·S T MorrisA G Jardine
Jul 26, 2000·Transplantation·A S MacDonald
Aug 31, 2000·Journal of the American Society of Nephrology : JASN·Bertram L KasiskeJoseph Roel
Sep 27, 2000·Journal of Endocrinological Investigation·P Marchetti, R Navalesi
Oct 26, 2001·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·R MooreH Valantine
Oct 30, 2001·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·M OstermannR Chang
Mar 5, 2002·Diabetes Care·Victor M MontoriYogish C Kudva
Mar 7, 2002·Annals of Epidemiology·Kevin C AbbottLawrence Y Agodoa
Mar 26, 2002·Journal of the American Society of Nephrology : JASN·Claudio RigattoJohn Jeffery
Jun 7, 2002·The New England Journal of Medicine·Marie-Claude MoriceUNKNOWN RAVEL Study Group. Randomized Study with the Sirolimus-Coated Bx Velocity Balloon-Expandable Stent in the Treatment of Patie
Jun 25, 2002·Clinical Nephrology·D DuclouxJ M Chalopin
Jul 12, 2002·Kidney International·Arthur J MatasDavid E R Sutherland
Jul 18, 2002·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Conrad B Blum
Sep 28, 2002·Journal of Cardiovascular Pharmacology·Lorenzo A CalòAndrea Semplicini
Oct 24, 2002·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Leslie W Miller
Jan 7, 2003·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Marc-André RaymondMarie-Josée Hébert
Jan 23, 2003·Journal of the American Society of Nephrology : JASN·Claudio RigattoPatrick Parfrey
Feb 18, 2003·Clinical Transplantation·Anna OliverasJosep Lloveras
Feb 27, 2003·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Bertram L KasiskeArthur J Matas
Apr 2, 2003·Circulation·Tetsuo ShioiSeigo Izumo
Apr 16, 2003·The American Journal of the Medical Sciences·Rubin ZhangEfrain Reisin
Jun 5, 2003·Clinical Transplantation·Huseyin OflazMehmet S Sever
Aug 2, 2003·Cardiovascular Radiation Medicine·Ron WaksmanDavid Hellinga
Aug 29, 2003·The New England Journal of Medicine·Howard J EisenUNKNOWN RAD B253 Study Group
Dec 25, 2003·Journal of the American Society of Nephrology : JASN·Giovanni StalloneFrancesco Paolo Schena
Mar 17, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Stefan VitkoNathalie Cretin
Mar 26, 2004·Transplantation Proceedings·R Calne
May 29, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Rahul M Jindal, Edward T Zawada
May 29, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Bertram L KasiskeJon J Snyder
Jun 12, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Angel Alonso, Juan Oliver
Jul 23, 2004·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Josep María GrinyoEnrique Granados
Sep 24, 2004·The New England Journal of Medicine·Alan S GoChi-yuan Hsu

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Citations

Nov 26, 2015·Transplantation Reviews·Oliver WitzkeWolfgang Arns
Oct 16, 2012·Clinical Transplantation·Georges MouradYvon Lebranchu
May 3, 2012·Transplant International : Official Journal of the European Society for Organ Transplantation·Ajay K IsraniUNKNOWN PORT Investigators
May 8, 2015·Advances in Medical Sciences·Paweł StróżeckiJacek Manitius
Sep 2, 2014·Journal of the European Academy of Dermatology and Venereology : JEADV·L AtzoriM Pau
Sep 18, 2014·Transplantation Reviews·Hallvard HoldaasFaouzi Saliba
Apr 2, 2014·Transplantation Reviews·Bruce KaplanJason R Wellen
Nov 29, 2014·Naunyn-Schmiedeberg's Archives of Pharmacology·Hanan M El-Gowelli, Mahmoud M El-Mas
Aug 21, 2018·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Burkhard TönshoffPatricia Lopez
Oct 22, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Faouzi SalibaFilomena Conti
Feb 17, 2021·Journal of Clinical Lipidology·Josephine L C AndersonUwe J F Tietge
Jul 29, 2021·World Journal of Transplantation·Marlene SchwarzenbachDaniel Sidler

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