Hypertension in renal transplantation: donor and recipient risk factors

Ducloux, Didier; Motte, G; Kribs, Marc; Aboubakr, Aiya; Bresson-Vautrin, Catherine; Rebibou, Jean-Michel; Chalopin, J M

doi:10.5414/cnp57409

Cited by 51 publications

(41 citation statements)

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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

836

870

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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

836

870

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“…The introduction of CNIs reduced the incidence of acute rejection (AR) episodes and improved early patient and graft survival. However, CNIs contribute to acute and chronic impairment of graft function and are associated with side effects that increase cardiovascular risk such as hypertension and diabetes (2)(3)(4)(5)(6)(7). Their effect on allograft function is worrisome because impaired renal function has been associated with poorer long-term graft survival (8).…”

Section: Introductionmentioning

confidence: 99%

Switching from Calcineurin Inhibitor-based Regimens to a Belatacept-based Regimen in Renal Transplant Recipients

Rostaing

Massari

Garcı́a

et al. 2011

Clinical Journal of the American Society of Nephrology

160

169

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SummaryBackground and objectives Prolonged use of calcineurin inhibitors (CNIs) in kidney transplant recipients is associated with renal and nonrenal toxicity and an increase in cardiovascular risk factors. Belatacept-based regimens may provide a treatment option for patients who switch from CNI-based maintenance immunosuppression.Design, setting, participants, & measurements This is a randomized, open-label Phase II trial in renal transplant patients with stable graft function and receiving a CNI-based regimen. Patients who were Ն6 months but Յ36 months after transplantation were randomized to either switch to belatacept or continue CNI treatment. All patients received background maintenance immunosuppression. The primary end point was the change in calculated GFR (cGFR) from baseline to month 12.Results Patients were randomized either to switch to belatacept (n ϭ 84) or to remain on a CNI-based regimen (n ϭ 89). At month 12, the mean (SD) change from baseline in cGFR was higher in the belatacept group versus the CNI group. Six patients in the belatacept group had acute rejection episodes, all within the first 6 months; all resolved with no allograft loss. By month 12, one patient in the CNI group died with a functioning graft, whereas no patients in the belatacept group had graft loss. The overall safety profile was similar between groups. ConclusionsThe study identifies a potentially safe and feasible method for switching stable renal transplant patients from a cyclosporine-or tacrolimus-based regimen to a belatacept-based regimen, which may allow improved renal function in patients currently treated with CNIs.

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“…O presente estudo mostrou que a hipertensão antes do transplante tende a permanecer assim após um ano, destacando a importância da hipertensão prévia como fator de risco para hipertensão pós-transplante renal, conforme demonstrado na literatura 2,7,17,21,22 . Além disso, nosso estudo mostrou tendência de menor sobrevida do enxerto renal nos pacientes que são hipertensos após um ano de transplante, porém sem diferença estatisticamente significante entre os grupos.…”

Section: Discussionunclassified

Influência da hipertensão na sobrevida do enxerto renal em pacientes pediátricos

Nagasako¹,

Nogueira²,

Machado³

et al. 2008

Rev. Assoc. Med. Bras.

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A comparação entre grupos foi realizada utilizando-se o teste do "log-rank". Para os testes adotamos o limite de 5% (α ≤ 0,05) para rejeição da hipótese de nulidade. RESULTADOS. Antes do transplante 86 pacientes (64%) e após um ano 70 indivíduos (52%) foram classificados como hipertensos, respectivamente. A sobrevida do enxerto renal após três anos de transplante foi de 92,5% para a amostra completa do estudo. O grupo de normotensos apresentou sobrevida de 95,3% e os hipertensos 90%; a diferença não foi estatisticamente significante. CONCLUSÃO. Apesar do resultado estatístico não ser significante, a diferença observada entre os dois grupos após três anos de transplante, de 5% maior sobrevida nos indivíduos que eram normotensos um ano após o transplante, nos parece clinicamente significativa e nos permite levantar a hipótese de que a hipertensão arterial pode ser um fator de risco para a sobrevida do enxerto pediátrico. Entretanto, não nos seria possível afirmar que a hipertensão é fator de risco independente para menor sobrevida do enxerto devido às limitações do estudo.UNITERMOS: Transplante renal pediátrico. Hipertensão. Sobrevida do enxerto.

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Hypertension in renal transplantation: donor and recipient risk factors

Cited by 51 publications

References 0 publications

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

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

Switching from Calcineurin Inhibitor-based Regimens to a Belatacept-based Regimen in Renal Transplant Recipients

Influência da hipertensão na sobrevida do enxerto renal em pacientes pediátricos

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