BACKGROUNDS/AIMS: Elevated uric acid (UA) levels are frequently observed after renal transplantation. We investigated the consequences of shifting from calcineurin inhibitors (CNI) to mammalian target of rapamycin inhibitors (mTORi) on UA levels and graft functions. METHODS: Ninety-six patients were enrolled. Main points of interest were changes in UA and glomerular filtration rate (GFR). RESULTS: Mean age of the whole population was 39 ± 11 years (18-73), and 64.2 % were male. Patients were stratified into two groups according to their CNI type prior to the switch as cyclosporin A (CsA) or tacrolimus (Tac). Patients that were switched from CsA had a mean GFR of 49 ± 18 ml/min and serum UA level of 7.4 ± 1.8 mg/dl at the pre-switch period. Mean GFR increased to 53 ± 22 ml/min (p = 0.03), and UA levels decreased to 6.2 ± 1.6 mg/dl at the final visit (p < 0.001). In the Tac group, pre-switch mean GFR was 59 ± 28 ml/min and serum UA level 6.6 ± 2.6 mg/dl. In this group, mean GFR increased to 63 ± 28 ml/min (p = 0.03) and UA levels decreased to 6.2 ± 2.1 at the last visit (p < 0.001). CONCLUSION: Switch from CNI to mTORi-based regimen provides better control of UA levels and improves renal functions.
BACKGROUNDS/AIMS: Elevated uric acid (UA) levels are frequently observed after renal transplantation. We investigated the consequences of shifting from calcineurin inhibitors (CNI) to mammalian target of rapamycin inhibitors (mTORi) on UA levels and graft functions. METHODS: Ninety-six patients were enrolled. Main points of interest were changes in UA and glomerular filtration rate (GFR). RESULTS: Mean age of the whole population was 39 ± 11 years (18-73), and 64.2 % were male. Patients were stratified into two groups according to their CNI type prior to the switch as cyclosporin A (CsA) or tacrolimus (Tac). Patients that were switched from CsA had a mean GFR of 49 ± 18 ml/min and serum UA level of 7.4 ± 1.8 mg/dl at the pre-switch period. Mean GFR increased to 53 ± 22 ml/min (p = 0.03), and UA levels decreased to 6.2 ± 1.6 mg/dl at the final visit (p < 0.001). In the Tac group, pre-switch mean GFR was 59 ± 28 ml/min and serum UA level 6.6 ± 2.6 mg/dl. In this group, mean GFR increased to 63 ± 28 ml/min (p = 0.03) and UA levels decreased to 6.2 ± 2.1 at the last visit (p < 0.001). CONCLUSION: Switch from CNI to mTORi-based regimen provides better control of UA levels and improves renal functions.
Authors: Marian Goicoechea; Soledad García de Vinuesa; Ursula Verdalles; Caridad Ruiz-Caro; Jara Ampuero; Abraham Rincón; David Arroyo; José Luño Journal: Clin J Am Soc Nephrol Date: 2010-06-10 Impact factor: 8.237
Authors: J M Morales; A Andrés; B Dominguez-Gil; M P Sierra; J Arenas; M Delgado; M C Casal; L Rodicio Journal: Transplant Proc Date: 2003-05 Impact factor: 1.066
Authors: Abdolreza Haririan; Joseph M Nogueira; Joseph M Noguiera; Kambiz Zandi-Nejad; Ravi Aiyer; Heather Hurley; Matthew Cooper; David K Klassen; Matthew R Weir Journal: Transplantation Date: 2010-03-15 Impact factor: 4.939