Blood Pressure and Graft Outcome in Renal Transplantation

Berber, İbrahim; Aydın, Çiğdem; Yiğit, Bülent; Yildar, Murat; Düzyol, Çağrı; Türkmen, F; Titiz, M.I.; Altaca, G

doi:10.1097/00007890-200407271-00859

Cited by 5 publications

(6 citation statements)

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“…There is a strong relationship between BP and graft function in adult renal transplant patients (2, 11, 12). Similar to other pediatric studies (13, 14, 20–22), we observed high rates of hypertension in our renal transplant population.…”

Section: Discussionmentioning

confidence: 99%

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Tracking of blood pressure and its impact on graft function in pediatric renal transplant patients

Silverstein

LeBlanc²,

Hempe

et al. 2007

Pediatric Transplantation

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We studied tracking of BP and its impact on GFR in 44 PRTP followed for 56 months. Three months PT 77% had elevated SBP percentile. First year SBP and DBP correlated positively with final values (p < 0.0001, 0.0002, respectively). Pretransplant and three month PT SBP correlated positively (p = 0.02). At one yr, SBP and DBP were inversely associated with GFR (p = 0.002, p < 0.0001, respectively). SBP and BMI were positively associated at all time points. DBP was significantly higher in deceased recipients throughout the study period. Final DBP was higher (p = 0.03) and GFR lower (p = 0.04) in African-American patients. Patients with end-stage renal disease caused by glomerular disease had higher SBP (p = 0.03) and DBP (p = 0.04) than those with congenital malformations. GFR at one-yr PT (p = 0.02) and end of study (p = 0.003) was significantly lower in patients with high BP. Moreover, patients who maintained a normal systolic BP throughout the study had a significantly higher final GFR than those who were hypertensive at both time points [84 (normal BP throughout) vs. 52 mL/min/1.73 m(2) (high BP throughout), p = 0.02]. We conclude that PT hypertension is common in PRTP and predicts lower GFR.

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Section: Discussionmentioning

confidence: 99%

“…For example, Berber et al. (11) showed that patients with hypertension six months after transplant have significantly higher serum creatinine levels one yr after transplant. Accordingly, long‐term graft function is improved with stringent BP control in adult renal transplant patients (12).…”

mentioning

confidence: 99%

Tracking of blood pressure and its impact on graft function in pediatric renal transplant patients

Silverstein

LeBlanc²,

Hempe

et al. 2007

Pediatric Transplantation

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“…In addition, since calcineurin inhibitors affect a broad range of nonimmunologic targets, they are associated with worsening hypertension (5), diabetes (6,7) and dyslipidemia (8), which can contribute to increased cardiovascular morbidity and mortality (9)(10)(11)(12)-the most common cause of death among transplant recipients 1 year posttransplant (13,14). (15) (19)(20)(21).…”

Section: Although Advances In Posttransplantation Immunosuppressive Mmentioning

confidence: 99%

A Phase III Study of Belatacept‐based Immunosuppression Regimens versus Cyclosporine in Renal Transplant Recipients (BENEFIT Study)

Vincenti

Charpentier

Vanrenterghem³

et al. 2010

American Journal of Transplantation

848

891

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“…Costimulation blockade minimizes the renal, cardiovascular and metabolic morbidities associated with current immunosuppressors, such as calcineurin inhibitors (CNI) and steroids (1)(2)(3). Costimulation by molecules of the CD28 family contributes to establishing the balance between regulatory and pathogenic effector mechanisms after initial antigen exposure.…”

Section: Introductionmentioning

confidence: 99%

FR104, an Antagonist Anti-CD28 Monovalent Fab’ Antibody, Prevents Alloimmunization and Allows Calcineurin Inhibitor Minimization in Nonhuman Primate Renal Allograft

Poirier

Dilek

Mary

et al. 2015

American Journal of Transplantation

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These authors contributed equally to the senior authorship of this study.Selective targeting of CD28 might represent an effective immunomodulation strategy by preventing T cell costimulation, while favoring coinhibition since inhibitory signals transmitted through CTLA-4; PD-L1 and B7 would not be affected. We previously showed in vitro and in vivo that anti-CD28 antagonists suppress effector T cells while enhancing regulatory T cell (Treg) suppression and immune tolerance. Here, we evaluate FR104, a novel antagonist pegylated anti-CD28 Fab' antibody fragment, in nonhuman primate renal allotransplantation. FR104, in association with low doses of tacrolimus or with rapamycin in a steroid-free therapy, prevents acute rejection and alloantibody development and prolongs allograft survival. However, when FR104 was associated with mycophenolate mofetil and steroids, half of the recipients rejected their grafts prematurely. Finally, we observed an accumulation of Helios-negative Tregs in the blood and within the graft after FR104 therapy, confirmed by Tregspecific demethylated region DNA analysis. In conclusion, FR104 reinforces immunosuppression in calcineurin inhibitor (CNI)-low or CNI-free protocols, without the need of steroids. Accumulation of intragraft Tregs suggested the promotion of immunoregulatory mechanisms. Selective CD28 antagonists might become an alternative CNI-sparing strategy to B7 antagonists for kidney transplant recipients.

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Blood Pressure and Graft Outcome in Renal Transplantation

Cited by 5 publications

References 0 publications

Tracking of blood pressure and its impact on graft function in pediatric renal transplant patients

Tracking of blood pressure and its impact on graft function in pediatric renal transplant patients

A Phase III Study of Belatacept‐based Immunosuppression Regimens versus Cyclosporine in Renal Transplant Recipients (BENEFIT Study)

FR104, an Antagonist Anti-CD28 Monovalent Fab’ Antibody, Prevents Alloimmunization and Allows Calcineurin Inhibitor Minimization in Nonhuman Primate Renal Allograft

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