Skip Navigation


NDT Advance Access originally published online on November 9, 2005
Nephrology Dialysis Transplantation 2006 21(2):488-493; doi:10.1093/ndt/gfi266
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
21/2/488    most recent
gfi266v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (22)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Saurina, A.
Right arrow Articles by Oppenheimer, F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Saurina, A.
Right arrow Articles by Oppenheimer, F.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Original Articles: Dialysis and Transplantation

Conversion from calcineurin inhibitors to sirolimus in chronic allograft dysfunction: changes in glomerular haemodynamics and proteinuria

Anna Saurina1, Josep M. Campistol2, Carlos Piera3, Fritz Diekmann2, Begoña Campos4, Nieves Campos3, Xavier de las Cuevas1 and Federico Oppenheimer2

1 Nephrology Department, Hospital de Terrassa, 2 Renal Transplant Unit, Hospital Clínic de Barcelona, 3 Nuclear Medicine Department, Hospital Clínic de Barcelona and 4 Statistics Department, Universitat de Barcelona, Spain

Correspondence and offprint requests to: Josep M. Campistol, Unidad de Trasplante Renal, Hospital Clínic, Villarroel 170, E-08036 Barcelona, Spain. Email: jmcampis{at}clinic.ub.es

Background. The study was conducted in order to describe possible intraglomerular haemodynamic changes inducing proteinuria after 14 patients with chronic allograft dysfunction were converted from calcineurin inhibitors (CIs) to sirolimus without changing concomitant immunosuppression or antihypertensive treatment.

Methods. Creatinine, glomerular filtration rate (GFR), proteinuria, renal functional reserve (RFR) and effective renal plasma flow (ERPF) were determined before and 8 months after conversion. Intraglomerular pressure (PG), afferent arteriolar resistance (AAR) and efferent arteriolar resistance (EAR) were calculated using Gomez's formula.

Results. Creatinine (1.97 vs 2.075 mg/dl; P = 0.270) and GFR (40 vs 43 ml/min; P = 0.505) remained unchanged, proteinuria increased (338 vs 1146 mg/24 h; P = 0.006), RFR decreased (34.84 vs 13.47%; P = 0.019), ERPF (248 vs 310.6 ml/min; P = 0.0625) and PG (42.72 vs 46.17 mmHg; P = 0.0625) tendentially increased and AAR tendentially decreased (14.12 vs 10.28 dyne/s/cm5; P = 0.0625).

Conclusion. After conversion, PG shows a tendency to increase and RFR decreases significantly—characteristics of hyperfiltration, which could possibly partially explain the increase of proteinuria. Therefore, the application of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers seems promising. To avoid hyperfiltration, conversion should be performed early when renal insufficiency is still moderate.

Keywords: calcineurin inhibitors; CAD; hyperfiltration; proteinuria; sirolimus


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Nephrol Dial TransplantHome page
S. L. Lui, R. Tsang, K. W. Chan, F. Zhang, S. Tam, S. Yung, and T. M. Chan
Rapamycin attenuates the severity of established nephritis in lupus-prone NZB/W F1 mice
Nephrol. Dial. Transplant., September 1, 2008; 23(9): 2768 - 2776.
[Abstract] [Full Text] [PDF]

Home page
 Annals of Clinical & Laboratory ScienceHome page
M. Nepal, R. Mainali, C. M. Schworer, W. Difilippo, P. L. Zhang, and M. F. Schultz
Nephrotic Range Proteinuria: Rare Manifestation of Scleroderma Renal Crisis
Ann. Clin. Lab. Sci., January 1, 2008; 38(2): 163 - 167.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Soc. Nephrol.Home page
F. Diekmann, J. Rovira, J. Carreras, E. M. Arellano, E. Banon-Maneus, M. J. Ramirez-Bajo, A. Gutierrez-Dalmau, M. Brunet, and J. M. Campistol
Mammalian Target of Rapamycin Inhibition Halts the Progression of Proteinuria in a Rat Model of Reduced Renal Mass
J. Am. Soc. Nephrol., October 1, 2007; 18(10): 2653 - 2660.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
F. Diekmann, A. Gutierrez-Dalmau, S. Lopez, F. Cofan, N. Esforzado, M. J. Ricart, E. Rossich, N. Saval, J. V. Torregrosa, F. Oppenheimer, et al.
Influence of sirolimus on proteinuria in de novo kidney transplantation with expanded criteria donors: comparison of two CNI-free protocols
Nephrol. Dial. Transplant., August 1, 2007; 22(8): 2316 - 2321.
[Abstract] [Full Text] [PDF]

Home page
 CJASNHome page
E. Letavernier, P. Bruneval, C. Mandet, J.-P. D. Van Huyen, M.-N. Peraldi, I. Helal, L.-H. Noel, and C. Legendre
High Sirolimus Levels May Induce Focal Segmental Glomerulosclerosis De Novo
Clin. J. Am. Soc. Nephrol., March 1, 2007; 2(2): 326 - 333.
[Abstract] [Full Text] [PDF]

Home page
 CJASNHome page
S. J. Tomlanovich and F. Vincenti
Sirolimus: Defining Nephrotoxicity in the Renal Transplant Recipient
Clin. J. Am. Soc. Nephrol., March 1, 2007; 2(2): 198 - 199.
[Full Text] [PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.