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

TitleConversion of ciclosporin A to tacrolimus in kidney transplant recipients with chronic allograft nephropathy
Authors
KeywordsChronic allograft nephropathy
Ciclosporin A
Minimization
Tacrolimus conversion
Issue Date2006
PublisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/
Citation
Nephrology Dialysis Transplantation, 2006, v. 21 n. 11, p. 3243-3251 How to Cite?
AbstractBackground. 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. © 2006 Oxford University Press.
Persistent Identifierhttp://hdl.handle.net/10722/77211
ISSN
2015 Impact Factor: 4.085
2015 SCImago Journal Rankings: 1.780
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTang, SCWen_HK
dc.contributor.authorChan, KWen_HK
dc.contributor.authorTang, CSOen_HK
dc.contributor.authorLam, MFen_HK
dc.contributor.authorLeung, CYen_HK
dc.contributor.authorTse, KCen_HK
dc.contributor.authorLi, CSen_HK
dc.contributor.authorHo, YWen_HK
dc.contributor.authorTong, MKLen_HK
dc.contributor.authorLai, KNen_HK
dc.contributor.authorChan, TMen_HK
dc.date.accessioned2010-09-06T07:29:28Z-
dc.date.available2010-09-06T07:29:28Z-
dc.date.issued2006en_HK
dc.identifier.citationNephrology Dialysis Transplantation, 2006, v. 21 n. 11, p. 3243-3251en_HK
dc.identifier.issn0931-0509en_HK
dc.identifier.urihttp://hdl.handle.net/10722/77211-
dc.description.abstractBackground. 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. © 2006 Oxford University Press.en_HK
dc.languageengen_HK
dc.publisherOxford University Press. The Journal's web site is located at http://ndt.oxfordjournals.org/en_HK
dc.relation.ispartofNephrology Dialysis Transplantationen_HK
dc.rightsNephrology, Dialysis, Transplantation. Copyright © Oxford University Press.en_HK
dc.subjectChronic allograft nephropathyen_HK
dc.subjectCiclosporin Aen_HK
dc.subjectMinimizationen_HK
dc.subjectTacrolimus conversionen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshChronic Diseaseen_HK
dc.subject.meshCreatinine - blooden_HK
dc.subject.meshCyclosporine - blood - therapeutic useen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGraft Rejection - blood - prevention & controlen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunosuppressive Agents - blood - therapeutic useen_HK
dc.subject.meshKidney Diseases - blood - drug therapy - therapyen_HK
dc.subject.meshKidney Transplantation - adverse effectsen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshProspective Studiesen_HK
dc.subject.meshTacrolimus - blood - therapeutic useen_HK
dc.titleConversion of ciclosporin A to tacrolimus in kidney transplant recipients with chronic allograft nephropathyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0931-0509&volume=21&issue=11&spage=3243&epage=51&date=2006&atitle=Conversion+of+ciclosporin+A+to+tacrolimus+in+kidney+transplant+recipients+with+chronic+allograft+nephropathyen_HK
dc.identifier.emailTang, SCW: scwtang@hku.hken_HK
dc.identifier.emailChan, KW: hrmtckw@hku.hken_HK
dc.identifier.emailLai, KN: knlai@hku.hken_HK
dc.identifier.emailChan, TM: dtmchan@hku.hken_HK
dc.identifier.authorityTang, SCW=rp00480en_HK
dc.identifier.authorityChan, KW=rp00330en_HK
dc.identifier.authorityLai, KN=rp00324en_HK
dc.identifier.authorityChan, TM=rp00394en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1093/ndt/gfl397en_HK
dc.identifier.pmid16877482-
dc.identifier.scopuseid_2-s2.0-33750023993en_HK
dc.identifier.hkuros125359en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33750023993&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume21en_HK
dc.identifier.issue11en_HK
dc.identifier.spage3243en_HK
dc.identifier.epage3251en_HK
dc.identifier.isiWOS:000241277100038-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridTang, SCW=7403437082en_HK
dc.identifier.scopusauthoridChan, KW=16444133100en_HK
dc.identifier.scopusauthoridTang, CSO=55225422400en_HK
dc.identifier.scopusauthoridLam, MF=35300050600en_HK
dc.identifier.scopusauthoridLeung, CY=7402612388en_HK
dc.identifier.scopusauthoridTse, KC=7102609864en_HK
dc.identifier.scopusauthoridLi, CS=36068236000en_HK
dc.identifier.scopusauthoridHo, YW=7402555047en_HK
dc.identifier.scopusauthoridTong, MKL=7202033848en_HK
dc.identifier.scopusauthoridLai, KN=7402135706en_HK
dc.identifier.scopusauthoridChan, TM=7402687700en_HK
dc.identifier.citeulike901763-

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