Renal function in patients with cadaveric kidney transplants treated with tacrolimus or cyclosporine.
BACKGROUND
Renal function predicts graft survival in kidney transplant patients. This study compared the 2-year evolution of renal function in patients treated with cyclosporine or tacrolimus in combination with mycophenolate mofetil (MMF) and prednisone.


METHODS
We studied 1558 cadaveric renal transplant recipients from 14 Spanish hospitals between January 2000 and December 2002. Of these, 1168 were treated with tacrolimus and 390 with cyclosporine. The primary efficacy endpoint was long-term renal function. Renal function was measured by serum creatinine and glomerular filtration rate (GFR) by creatinine clearance calculated from the Cockcroft-Gault formula. This report summarizes the 2-year results.


RESULTS
At 24 months the tacrolimus group showed significantly better serum creatinine (1.5 +/- 0.7 vs 1.8 +/- 0.8 mg/dL, P < .001) and GFR (60.5 +/- 20.9 mL/min vs 47.9 +/- 10.0, P < .001) than the cyclosporine group. Additionally, recipients with ideal graft donors (23.5 +/- 2.8 vs 24.0 +/- 2.9 years) had a better serum creatinine at 2 years (1.23 +/- 0.2 vs 1.5 +/- 0.4 mg/dL, P < .05). Multivariate analysis showed that tacrolimus was an independent factor associated with better renal function: odds ratio 1.6, 95% confidence interval (1.2 to 2.2), P < .001.


CONCLUSIONS
Patients with a renal transplant treated with tacrolimus in combination with MMF and prednisone displayed better renal function at 2 years than those who received cyclosporine.
Gonzalez Molina
M
M
Department of Nephrology and the Kidney Transplantation Unit, Carlos Haya, Malaga, Spain. mgonmol@yahoo.es
Morales
J M
JM
Marcen
R
R
Campistol
J M
JM
Oppenheimer
F
F
Serón
D
D
Gil-Vernet
S
S
Capdevila
L
L
Andrés
A
A
Lampreave
I
I
Del Castillo
D
D
Cabello
M
M
Burgos
D
D
Valdés
F
F
Anaya
F
F
Escuín
F
F
Arias
M
M
Pallardó
L
L
Bustamante
J
J
D000328:Adult; D000368:Aged; D002102:Cadaver; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use*; D014019:Tissue Donors
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus