Progression of renal dysfunction in cardiac transplantation after the introduction of everolimus in the immunosuppressive regime.
The aim of this study was to analyze, in heart transplant patients, if renal function improvement after cyclosporine replacement by everolimus persists at the middle term and its predictors. We studied prospectively 56 patients in whom conversion was consecutively made. Forty-five patients completed the follow-up period. Significant improvement was observed at 6 and 12 months in plasma creatinine levels (1.92+/-0.7 vs. 1.67+/-0.6 and 1.69+/-0.6 mg/dL; P=0.047) and glomerular filtration rate (43.9+/-17 vs. 52.5+/-23 and 51.3+/-22.3 mL/min; P=0.004). Glomerular filtration rate increased in 32 patients (71%). Baseline characteristics comparison showed a lower percentage of patients with smoking history and new onset diabetes in responders group, but only previous smoking was shown as independent factor (Exp B: 0.083; 95% confidence interval: 0.010-0.793; P=0.024). No differences regarding age, gender, body mass index, disease leading to transplantation, time between transplantation and replacement, cardiovascular risk factors, lipid levels, and hematologic parameters were found.
Moro López
Jose A
JA
Heart Failure and Transplant Unit, Cardiology, UH La Fe, Valencia, Spain. moro@uv.es
Almenar
Luis
L
Martínez-Dolz
Luis
L
Sánchez-Lázaro
Ignacio
I
Agüero
Jaime
J
Buendía
Francisco
F
Ortiz
Víctor
V
Salvador
Antonio
A
D003920:Diabetes Mellitus / Q000453:epidemiology; D018450:Disease Progression; D000068338:Everolimus; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D016027:Heart Transplantation / Q000009:adverse effects* / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D011183:Postoperative Complications / Q000453:epidemiology; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives*; D012907:Smoking / Q000009:adverse effects
D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus