Premium
Proteinuria after conversion to sirolimus in kidney transplant recipients: impact of pre‐existing proteinuria, graft function, and angiotensin‐converting enzyme inhibitors/angiotensin‐receptor antagonists
Author(s) -
Marx Christian,
Busch Martin,
Ott Undine,
Gerth Jens,
Wolf Gunter
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01142.x
Subject(s) - proteinuria , medicine , renal function , sirolimus , urology , angiotensin converting enzyme , endocrinology , losartan , kidney , angiotensin ii , receptor , blood pressure
Marx C, Busch M, Ott U, Gerth J, Wolf G. Proteinuria after conversion to sirolimus in kidney transplant recipients: impact of pre‐existing proteinuria, graft function, and angiotensin‐converting enzyme inhibitors/angiotensin‐receptor antagonists.
Clin Transplant 2009 DOI:10.1111/j.1399‐0012.2009.01142.x.
© 2009 John Wiley & Sons A/S. Abstract: Background: Proteinuria is a known side effect of therapy with sirolimus. The effect of angiotensin‐converting enzyme inhibitors or angiotensin‐receptor blockers (ACEI/ARB ) on sirolimus‐associated proteinuria has not yet been assessed. Patients and methods: A retrospective cohort study of renal transplant patients treated with sirolimus (n = 55) was performed. Results: Of 55 patients, 24 (44%) had no proteinuria (<0.15 g/d) prior to conversion. Of 24 patients, 11 (46%) showed de novo proteinuria >0.15 g/d after 12 months, only 2 developed proteinuria > 1 g/d. The total number of proteinuria >1 g/d after 12 months including patients with pre‐existing proteinuria >1 g/d (n = 3) was seven of 55 patients (13%). Multivariate regression analysis revealed pre‐existing proteinuria > 0.15 g/d and reduced glomerular filtration rate as independent predictors for the development of proteinuria after conversion to sirolimus. Conclusion: Reduced glomerular filtration rate and pre‐existing proteinuria but not therapy with ACEI/ARB are independent predictors for proteinuria after conversion to sirolimus. Treatment with ACEI/ARB did not reduce pre‐existing proteinuria after conversion except in single cases with severe proteinuria.