Skip Navigation

This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
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 (16)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Zaltzman, J. S.
Right arrow Articles by Prasad, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Zaltzman, J. S.
Right arrow Articles by Prasad, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Nephrol Dial Transplant (2004) 19: 940-944
Nephrol Dial Transplant Vol. 19 No. 4 © ERA-EDTA 2004; all rights reserved

Original Article

The benefits of renin–angiotensin blockade in renal transplant recipients with biopsy-proven allograft nephropathy

Jeffrey S. Zaltzman, Michelle Nash, Rick Chiu and Ramesh Prasad

Renal Transplant Program, Division of Nephrology, St Michael's Hospital, Department of Medicine, University of Toronto, Toronto, Ontario, Canada

Correspondence and offprint requests to: Dr Jeffrey S. Zaltzman, Director of Renal Transplantation, Division of Nephrology, Dept of Medicine, University of Toronto, St Michael's Hospital, 30 Bond St, Toronto, Ontario, Canada M5B 1W8. Email: jeffrey.zaltzman{at}utoronto.ca

Background. Allograft nephropathy, regardless of aetiology, leads to progressive renal injury and eventual graft loss. In native kidney disease, treatment of hypertension, in particular with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB), has proven beneficial in retarding renal function decline. In the present study, we reviewed the clinical course of a renal transplant recipient cohort that was prescribed either an ACEi or ARB for biopsy-proven allograft nephropathy.

Methods. Patients were followed from the time of post-biopsy initiation of ACEi/ARB and were stratified based on biopsy findings. Outcomes of interest included safety, allograft survival, renal function and change in slope of renal function pre- and post-ACEi/ARB.

Results. The 5 year allograft survival after biopsy diagnosis of allograft nephropathy was 83%. Serum creatinine was 191±97 (86–377) µmol/l at the time of biopsy and 228±102 (102–575) µmol/l at last follow-up. The slopes of reciprocal creatinine vs time were used to calculate the decline in renal function and were compared pre- and post-ACEi/ARB. The mean slope±SD was –0.06±0.21 l/µmol x 10–3 per month in the 12 months prior to therapy and –0.03±0.09 l/µmol x 10–3 per month following therapy. The absolute difference in slopes was 0.03 (P =<0.0001).

Conclusions. Treatment with ACEi/ARB may be beneficial in the management of allograft nephropathy.

Keywords: allograft nephropathy; angiotensin-converting enzyme inhibitors; angiotensin receptor antagonists


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




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.