Skip Navigation


NDT Advance Access originally published online on July 28, 2006
Nephrology Dialysis Transplantation 2006 21(11):3243-3251; doi:10.1093/ndt/gfl397
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
21/11/3243    most recent
gfl397v1
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 arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Tang, S. C.-W.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Tang, S. C.-W.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Conversion of ciclosporin A to tacrolimus in kidney transplant recipients with chronic allograft nephropathy

Sydney Chi-Wai Tang, Kwok Wah Chan, Colin Siu-On Tang, Man Fai Lam, Chung Ying Leung, Kai Chung Tse, Chun Sang Li, Yiu Wing Ho, Matthew Kwok-Lung Tong, Kar Neng Lai, Tak Mao Chan and for the Hong Kong Nephrology Study Group{dagger}

Division of Nephrology, Department of Medicine, University of Hong Kong and Queen Mary Hospital, Hong Kong, China

Correspondence and offprint requests to: Prof. T. M. Chan, Department of Medicine, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China. Email: dtmchan{at}hku.hk

Background. Tacrolimus and ciclosporin might have different effects on intra-renal fibrosis and allograft function in chronic allograft nephropathy (CAN). It is difficult to predict the response to calcineurin inhibitor minimization in patients with CAN.

Methods. This prospective randomized study compared ciclosporin A (CsA)-to-tacrolimus conversion (group A, target tacrolimus trough level 6–8 ng/ml) vs CsA minimization (group B, target CsA trough level 80–100 ng/ml) with regard to efficacy and safety in patients with CAN and deteriorating allograft function. The primary efficacy endpoint was improvement in the slope of inverse serum creatinine (1/SCr) vs time plot.

Results. There were 34 evaluable patients (n = 16 in group A; n = 18 in group B), with similar baseline characteristics. Both groups reached target drug levels after a 3-month run-in period. Over the ensuing 12 months, nine (56.3%) subjects in group A and 10 (55.6%) in group B reached the primary end point (P = 0.968). Both groups showed considerable improvement in the slope of 1/SCr vs time plot. There was no significant difference in the slope between groups before and after intervention. Graft survival was 87% in group A and 100% in group B (P = 0.121). Acute rejection was encountered in two group A subjects. There was no significant change or difference in blood glucose, lipids, and blood pressure between groups.

Conclusion. Our results suggest that in patients with CAN and deteriorating allograft function, CsA-to-tacrolimus conversion or CsA minimization achieved comparable efficacies in retarding the decline of graft function. Such contention may be biased by the low patient number. Further studies with a larger cohort are needed for validation.

Keywords: chronic allograft nephropathy; ciclosporin A; minimization; tacrolimus conversion

{dagger} Please refer to Appendix for participants in the Study Group.


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
 CJASNHome page
L. M. Birnbaum, M. Lipman, S. Paraskevas, P. Chaudhury, J. Tchervenkov, D. Baran, A. Herrera-Gayol, and M. Cantarovich
Management of Chronic Allograft Nephropathy: A Systematic Review
Clin. J. Am. Soc. Nephrol., April 1, 2009; 4(4): 860 - 865.
[Abstract] [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.