BACKGROUND: Sirolimus is an alternative option for kidney transplant patients treated with calcineurin inhibitors (CNI) when renal function is deteriorating. However, the incidence of proteinuria following a switch from CNI to sirolimus has caused concern, and was therefore investigated here. METHODS: In a retrospective study, 68 renal transplant recipients were switched from CNI to sirolimus. Proteinuria was measured using 24-hour urine collection before the switch and collections 3, 6, 12, and 24 months thereafter. In addition, proteinuria was measured in patients who had to be switched back to CNI due to side effects. Survival analyses were performed. RESULTS: Baseline proteinuria was 0.39+/-0.69 g/day in all 68 patients. It increased to a mean 1.44+/-1.90 g/day at 3 months (P<0.001) and remained elevated at 6, 12 and 24 months. When sirolimus was withdrawn after the CNI-sirolimus switch for 19 patients, proteinuria decreased from 1.95+/-2.06 g/day to 0.9+/-1.4 g/day (P<0.05). Proteinuria above 0.3 g/day before the CNI-sirolimus switch correlated significantly with the decrease of renal function thereafter. CONCLUSION: CNI-treated kidney transplant recipients may develop reversible proteinuria when switched to sirolimus.
BACKGROUND:Sirolimus is an alternative option for kidney transplantpatients treated with calcineurin inhibitors (CNI) when renal function is deteriorating. However, the incidence of proteinuria following a switch from CNI to sirolimus has caused concern, and was therefore investigated here. METHODS: In a retrospective study, 68 renal transplant recipients were switched from CNI to sirolimus. Proteinuria was measured using 24-hour urine collection before the switch and collections 3, 6, 12, and 24 months thereafter. In addition, proteinuria was measured in patients who had to be switched back to CNI due to side effects. Survival analyses were performed. RESULTS: Baseline proteinuria was 0.39+/-0.69 g/day in all 68 patients. It increased to a mean 1.44+/-1.90 g/day at 3 months (P<0.001) and remained elevated at 6, 12 and 24 months. When sirolimus was withdrawn after the CNI-sirolimus switch for 19 patients, proteinuria decreased from 1.95+/-2.06 g/day to 0.9+/-1.4 g/day (P<0.05). Proteinuria above 0.3 g/day before the CNI-sirolimus switch correlated significantly with the decrease of renal function thereafter. CONCLUSION: CNI-treated kidney transplant recipients may develop reversible proteinuria when switched to sirolimus.
Authors: F Cortazar; M Z Molnar; T Isakova; M E Czira; C P Kovesdy; D Roth; I Mucsi; M Wolf Journal: Am J Transplant Date: 2011-11-04 Impact factor: 8.086
Authors: Guillaume Canaud; Frank Bienaimé; Amandine Viau; Caroline Treins; William Baron; Clément Nguyen; Martine Burtin; Sophie Berissi; Konstantinos Giannakakis; Andrea Onetti Muda; Stefan Zschiedrich; Tobias B Huber; Gérard Friedlander; Christophe Legendre; Marco Pontoglio; Mario Pende; Fabiola Terzi Journal: Nat Med Date: 2013-09-22 Impact factor: 53.440
Authors: T Isakova; H Xie; S Messinger; F Cortazar; J J Scialla; G Guerra; G Contreras; D Roth; G W Burke; M Z Molnar; I Mucsi; M Wolf Journal: Am J Transplant Date: 2012-10-01 Impact factor: 8.086