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Cardiovascular and Renal Outcomes of Renin-Angiotensin System Blockade in Renal Transplant Recipients.

Abstract：

BACKGROUND:There is considerable controversy over the benefits of renin-angiotensin system (RAS) blockade in renal transplant recipients (RTRs). The aim of the study was to research the effects of RAS blockade on allograft and patient outcome. METHODS:A retrospective analysis of the effects of RAS blockade on allograft and patient outcome in 53 pairs of RTRs receiving grafts from the same donor was performed. The 106 RTRs (53 pairs), transplanted from 2002 to 2012, were included in the study when 1 patient from the pair used an angiotensin converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) for a minimum period of 36 months (RAS[+]) and the second one did not use it (RAS[-]). RESULTS:There were no differences between RAS(+) and RAS(-) subjects in terms of age, body mass index, reason of end-stage renal disease, mismatches number, total ischemic time, episodes of cytomegalovirus infections, acute rejections, and immunosuppressive treatment. The mean time of observations was 66.28 months ± 24.39 months. RAS inhibitors were given in a mean dose of 23.1% (ACEI) and 27.08% (ARB) of the maximum recommended. The main reasons for the therapy were as follows: hypertension (39.62%), nephroprotection/proteinuria (39.62%), and polyglobulia (28.3%). The composite cardiorenal endpoint was reached by 6 (11.32%) and 7 (13.21%) patients in RAS(+) and RAS(-) group, respectively. There were no differences in changes of creatinine, potassium serum level, or estimated glomerular filtration rate between RAS(+) and RAS(-) patients in the early period after RAS blockade commencement. CONCLUSION:Agents inhibiting the RAS system neither improved nor deteriorated patients and graft survival in RTRs.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Zakrzewska A,Tylicki L,Debska-Slizien A

doi

10.1016/j.transproceed.2018.02.118

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

1834-1837

issue

6

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(18)30305-1

journal_volume

50

pub_type

杂志文章

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