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01-11-2009 | Original Article

Conversion to sirolimus of patients with chronic allograft nephropathy—a retrospective analysis of outcome and influencing factors

Authors: Oliver Witzke, Ondrej Viklicky, Tobias R. Türk, Jens Lutz, Benjamin Wilde, Isabel Willenberg, Stefan Vitko, Uwe Heemann

Published in: Langenbeck's Archives of Surgery | Issue 6/2009

Abstract

Purpose

The purpose of this study was to analyse the outcome and its influencing factors in patients whose therapy was converted from calcineurin inhibitors (CNI) to sirolimus (SRL) due to chronic allograft nephropathy (CAN).

Materials and methods

Therapies of 78 patients (44 men) with CAN from three European transplant centres were converted from CNI therapy to SRL and followed 24 months. Slopes for creatinine clearance before and after conversion were calculated. Influencing factors were analysed by a multivariance analysis.

Results

The slope of the creatinine clearance improved significantly (−0.90 vs. −0.34 ml min⁻¹ month⁻¹; p < 0.01). In patients whose therapy was converted from cyclosporine A (CyA) to SRL, the slope improved significantly, whereas conversion from Tacrolimus (Tac) to SRL did not affect the slope. The benefit was more pronounced in (1) patients with low or moderate baseline creatinine clearance, (2) patients receiving SRL after conversion without additional mycophenolate mofetil and (3) patients with low or moderate proteinuria.

Conclusion

Conversion from CyA to SRL but not from Tac to CRL is associated with a reduced loss of renal allograft function in patients with CAN.

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Title: Conversion to sirolimus of patients with chronic allograft nephropathy—a retrospective analysis of outcome and influencing factors
Authors: Oliver Witzke
Ondrej Viklicky
Tobias R. Türk
Jens Lutz
Benjamin Wilde
Isabel Willenberg
Stefan Vitko
Uwe Heemann
Publication date: 01-11-2009
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 6/2009
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-008-0435-y

At a glance: The STEP trials

Springer Medicine

Conversion to sirolimus of patients with chronic allograft nephropathy—a retrospective analysis of outcome and influencing factors

Abstract

Purpose

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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