H-Index
70
Scimago Lab
powered by Scopus
Clarivate
Analytics
Formerly the IP & Science
business of Thomson Reuters

Logo




eISSN: 1643-3750

Get your full text copy in PDF

Immunosuppressive regimen and prevalence of chronic kidney disease in orthotopic heart transplant recipients

Piotr Przybylowski, Jolanta Malyszko, Jacek Malyszko

Med Sci Monit 2010; 16(11): CR563-566

ID: 881226


Background:    Heart transplantation is an established treatment for advanced heart failure. Heart transplant recipients experience a number of complications related to pharmacological immunosuppression and infections. Chronic kidney disease (CKD) is an important long-term complication of all forms of organ transplantation other than renal. It has been shown that a GFR <60ml/min is predictive of premature cardiovascular death. The aim of our study was to assess kidney function in relation to the type of immunosuppression regimen used.
    Material/Methods:    We analyzed 169 patients who underwent their first orthotopic heart transplant. The immunosuppressive regimen of prevalent patients consisted of tacrolimus (n=60), cyclosporine (n=109), in combination with mycophenolate mofetil (n=134), azathioprine (n=4), everolimus (n=28) or sirolimus (n=8). GFR was estimated using 3 formulae: CKD-EPI, MDRD and the Cockcroft-Gault. Complete blood count, urea, serum lipids, fasting glucose, creatinine, and NT-proBNP were also analyzed.
    Results:    In patients treated with tacrolimus, we observed a higher eGFR (all formulae), a greater 24-hour creatinine clearance, and lower serum cholesterol, LDL-cholesterol and triglyceride values than in patients treated with cyclosporine. Patients treated with tacrolimus were younger than those treated with cyclosporine. However, the time elapsed after OHT was similar in both groups. The prevalence of CKD (eGFR <60 ml/min) in the tacrolimus-treated patients was 45%, whereas in the cyclosporine treated group it was 87% (p<0.01).
    Conclusions:    The prevalence of CKD is high in heart transplant recipients. Tacrolimus-based immunosuppression was associated with better kidney function and more favorable lipid profile. Evaluation of renal function is important in order to select the appropriate strategy by individually tailored therapy to achieve the best possible outcomes.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
I agree