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Título: Early steroid withdrawal in a renal transplant cohort treated with tacrolimus, mycophenolate mofetil and basiliximab [Retiro temprano de esteroides en una cohorte de trasplante renal tratada con tacrolimus, mofetil micofenolato y basiliximab]
Autor: Andrade-sierra, J.
Rojas-campos, E.
Cardona-munoz, E.
Evangelista-carrillo, L.A.
Puentes-camacho, A.
Lugo-lopez, O.
Gomez, B.
Valdespino, C.
Cerrillos, I.
Medina-perez, M.
Jalomo, B.
Nieves, J.J.
Sandoval, M.
Ramos-solano, F.
Monteon-ramos, F.
Cueto-manzano, A.M.
Fecha de publicación: 2014
Resumen: Background: Acute rejection and graft function have not been completely clarified in early-steroid-withdrawal (ESW) patients. The objective of this study was to compare the effect of early steroid withdrawal on GFR, graft survival/rejection in recipients in a cohort treated with tacrolimus/mycophenolate mofetil compared to a control cohort. Material and method: Retrospective cohort, in 60 low immunological risk recipients between December 2005 and July 2010. Study cohort (ESW-C N=32), steroid withdrawal was carried out after 5 days, while they were receiving tacrolimus/mycophenolate mofetil. The control cohort (C-C, N=28) received prednisone/tacrolimus/mycophenolate mofetil. Clinical, biochemical and histological variables were assessed at baseline and after 3, 6, and 12 months of followup. Kaplan-Meier and the Cox proportional hazards model were used to assess survival. Comparisons between cohorts were carried out by the Student's t and ?2 tests. Results: At follow-up, C-C displayed significantly higher systolic (125Zapotitlán10 vs. 114Zapotitlán8) and diastolic (81Zapotitlán8 vs. 72Zapotitlán7) blood pressure, serum glucose (96Zapotitlán13 vs. 86Zapotitlán10), triglycerides (177Zapotitlán61 vs. 129Zapotitlán34), total (183Zapotitlán43 vs. 148Zapotitlán34) and LDL-cholesterol (100Zapotitlán22 vs. 87Zapotitlán25). C-C had a higher proportion of antihypertensive (57 vs. 13%), and statins (27 vs. 9%) use. eGFR was better in ESW-C than in C-C (85.4Zapotitlán20.6 vs. 70.6Zapotitlán17.0, P=.004). AR frequency was lower in ESW-C. Conclusions: Graft survival, GFR, AR rate and metabolic profile were better in the ESW-C than in C-C. Zapotitlán 2014 Revista Nefrología. Zapotitlánrgano Oficial de la Sociedad Española de Nefrología.
URI: http://hdl.handle.net/20.500.12104/40844
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