Mycophenolate mofetil substitution for cyclosporine A in renal transplant recipients with chronic progressive allograft dysfunction: the creeping creatinine study

Mycophenolate mofetil substitution for cyclosporine A in renal transplant recipients with chronic progressive allograft dysfunction: the creeping creatinine study

Autor Dudley, C. Google Scholar
Pohanka, E. Google Scholar
Riad, H. Google Scholar
Dedochova, J. Google Scholar
Wijngaard, P. Google Scholar
Sutter, C. Google Scholar
Silva, H. T. Google Scholar
Mycophenolate Mofetil Creep Google Scholar
Instituição Southmead Gen Hosp
Univ Vienna
Manchester Royal Infirm
Internal Clin FNsP
F Hoffman La Roche Ltd
Universidade Federal de São Paulo (UNIFESP)
Resumo Background. This study determined whether cyclosporine A (CsA)-treated renal allograft recipients with deteriorating renal function (creeping creatinine) secondary to chronic allograft nephropathy (CAN) benefit from the addition of mycophenolate mofetil (MMF) to their immunosuppressive regimen, followed by withdrawal of CsA.Methods. in a controlled, open, multicenter study, CsA-treated renal allograft recipients with progressively deteriorating renal function were randomized to have their CsA discontinued with the concomitant addition of MMF to their regimen (group A) or to continue treatment with CsA (group B). the primary endpoint was the response rate over the 6-month period after withdrawal of CsA in group A or the equivalent time in group B. Response was defined as a stabilization or reduction of serum creatinine (SCr), as evidenced by a flattening or positive slope of the 1/SCr plot and no graft loss. Secondary endpoints included the incidence of acute rejection, graft and patient survival, and changes in selected metabolic parameters.Results. the response rate in the primary intent-to-treat population (n = 122) was 58% (36/62) in group A versus 32% (19/60) in group B (P= 0.0060). the corresponding percentages of responders in the per-protocol population (n = 107) were 60% (36/60) and 26% (12/47), respectively (P=0.0008). There were no acute rejections in group A during the study period. Patients in this group also experienced a significant decrease in total cholesterol.Conclusions. in patients with progressively deteriorating renal function secondary to CAN, addition of MMF followed by withdrawal of CsA results in a significant improvement in transplant function without the risk of acute rejection.
Assunto mycophenolate mofetil
chronic allograft nephropathy
renal transplant
cyclosporine A nephrotoxicity
creeping creatinine
Idioma Inglês
Data 2005-02-27
Publicado em Transplantation. Philadelphia: Lippincott Williams & Wilkins, v. 79, n. 4, p. 466-475, 2005.
ISSN 0041-1337 (Sherpa/Romeo, fator de impacto)
Editor Lippincott Williams & Wilkins
Extensão 466-475
Fonte http://dx.doi.org/10.1097/01.TP.0000151632.21551.00
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000227196300013
URI http://repositorio.unifesp.br/handle/11600/28157

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