Improved renal function, with similar proteinuria, after two years of early tacrolimus withdrawal from a regimen of sirolimus plus tacrolimus

Transplantation
José María MoralesJorge A Munoz-Robles

Abstract

Results at 1 year of a pilot randomized trial with 87 kidney graft recipients, comparing the maintenance treatment with sirolimus, tacrolimus and steroids (group I) versus tacrolimus withdrawal since the third month onward, followed by maintenance with SRL and steroids (group II) have shown that early elimination of tacrolimus may result in improved renal function and blood pressure control. At 2 years, 26 and 25 patients in groups I and II, respectively, were analyzed in an on-therapy and an ITT analysis. In the on-therapy analysis, group II showed lower serum creatinine (1.3+/-0.2 vs. 1.6+/-0.6 mg/dL) and lower diastolic blood pressure (74+/-9 vs. 80+/-11 mm Hg). No acute rejections occurred during the second year of follow-up. In more than 90% of patients, proteinuria was less than 1 g/d, and in 50% it was negative. In the ITT analysis, differences were found only in diastolic blood pressure (80+/-10 vs. 74+/-8 mm Hg in groups I and II respectively, P=0.009). Tacrolimus withdrawal from a combination of sirolimus and tacrolimus, in selected patients, may be observed at 2 years by an improvement in renal function and blood pressure without a higher incidence of proteinuria.

References

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Citations

May 31, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·K BuddeUNKNOWN ZEUS Study Investigators
Jul 21, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·L MjörnstedtH Holdaas
Jul 21, 2010·Transplant International : Official Journal of the European Society for Organ Transplantation·Martin Zeier, Markus Van Der Giet
Jul 30, 2014·Transplant International : Official Journal of the European Society for Organ Transplantation·Frank LehnerUNKNOWN ZEUS Study Investigators
Sep 18, 2014·Transplantation Reviews·Hallvard HoldaasFaouzi Saliba
Jun 13, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Klemens BuddeUNKNOWN HERAKLES Study Group
Dec 17, 2019·The Cochrane Database of Systematic Reviews·Deirdre HahnAngela C Webster
Jul 22, 2017·The Cochrane Database of Systematic Reviews·Krishna M KarpeGiles D Walters
Feb 11, 2020·Frontiers in Pharmacology·Xianchun DuanDaiyin Peng

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