title: Treatment with sirolimus is associated with less weight gain after kidney transplantation.
abstract: BACKGROUND
  Immunosuppression after kidney transplantation has been associated with weight gain. The aim was to evaluate if sirolimus (SRL) had a different effect on weight gain than calcineurin inhibitor (CNI).
  
  
  METHODS
  Data on body weight in different patient populations were analyzed at several time points: (a) SRL (CNI-free) versus cyclosporine A (CsA) treatment de novo, (b) CsA+SRL versus CsA (SRL-free) treatment de novo, (c) SRL+tacrolimus elimination at 3 months versus SRL+mycophenolate mofetil versus tacrolimus+mycophenolate mofetil de novo, and (d) conversion from CNI to SRL versus CNI in maintenance patients.
  
  
  RESULTS
  Patients were analyzed from de novo transplantation trials (n=1863) and from the conversion study (n=742). At baseline, weight in the SRL-containing and SRL-free treatment arms was not different, but weight gain was significantly less pronounced in SRL in de novo treatment (group 1: 2.8±4.6 vs. 6.2±6.6 kg every 2 years, P=0.020; group 2: 6.1±9.5 vs. 9.6±9.1 kg every 2 years, P<0.001; and group 3: 3.7±7.0 vs. 3.5±6.2 vs. 5.9±9.0 kg every 1 year, P=0.042). In the conversion study, patients lost weight in the SRL arm and gained weight in the CNI arm (-1.0±6.0 vs. +1.0±5.1 kg every 2 years; P<0.001).
  
  
  CONCLUSIONS
  SRL treatment is associated with less weight gain de novo as well as in late conversion.
authors.affiliation: Department of Nephrology and Renal Transplantation, Hospital Clínic, Barcelona, Spain. fdiekman@clinic.ub.es
authors.forename: Fritz
authors.initials: F
authors.lastname: Diekmann
authors.forename: Josep M
authors.initials: JM
authors.lastname: Campistol
authors.forename: Jordi
authors.initials: J
authors.lastname: Rovira
authors.forename: Klemens
authors.initials: K
authors.lastname: Budde
authors.forename: Hans-Hellmut
authors.initials: HH
authors.lastname: Neumayer
authors.forename: Federico
authors.initials: F
authors.lastname: Oppenheimer
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Flechner
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D065095:Calcineurin Inhibitors; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000494:pharmacology*; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D001786:Blood Glucose; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D058570:TOR Serine-Threonine Kinases; D020123:Sirolimus