Low-dose mycophenolate mofetil is an effective and safe treatment to permit phased reduction in calcineurin inhibitors in chronic allograft nephropathy.

Abstract:

BACKGROUND:Chronic allograft nephropathy (CAN) is the most common cause of long-term renal-allograft dysfunction and the second most common cause of transplant loss. There are concerns that prolonged patient exposure to calcineurin inhibitors (CNIs) exacerbates or promotes the process of CAN. METHODS:In our unit, we carried out an observational study over the period 2000 to 2003 using low-dose mycophenolate mofetil (MMF) to facilitate a phased reduction in the dose of CNI in a group of patients with CAN. Low doses of MMF were chosen to minimize adverse effects and to reduce levels of CNIs without the attendant risks of under-immunosuppression. RESULTS:A step-wise reduction in mean reciprocalised creatinine was evident over the run-in period (mean 1/creatinine before MMF=0.005739-0.000083*month; R=0.77) with a step-wise monthly improvement postintroduction of MMF and dose reduction of CNI (mean 1/creatinine after MMF=0.004609+0.000049*month; R=0.74) (P<0.0001). The mean Cockroft-Gault estimated creatinine clearances were 47.1+/-24.2, 37.2+/-16.3, and 41.6+/-21.1 mL/min at time [t]=-12, t=0 and t=+12 months, respectively. Low-dose MMF therapy was well tolerated (only 7/89 patients stopped MMF because of side-effects in the first 12 months), and acute rejection was noted in only one patient. At latest follow-up, only 17 transplant losses had occurred, of which 6 patients had died with a functioning graft. CONCLUSIONS:Low-dose MMF was well tolerated and resulted in prolonged graft survival.

journal_name

Transplantation

journal_title

Transplantation

authors

Afzali B,Shah S,Chowdhury P,O'sullivan H,Taylor J,Goldsmith D

doi

10.1097/01.tp.0000151145.12706.2a

subject

Has Abstract

pub_date

2005-02-15 00:00:00

pages

304-9

issue

3

eissn

0041-1337

issn

1534-6080

pii

00007890-200502150-00007

journal_volume

79

pub_type

临床试验,杂志文章
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    更新日期:2004-09-27 00:00:00

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    pub_type: 杂志文章

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    authors: Gottrand F,Michaud L,Bonnevalle M,Dubar G,Pruvot FR,Turck D

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    pub_type: 杂志文章

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    更新日期:2006-01-27 00:00:00

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    pub_type: 临床试验,杂志文章,随机对照试验

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    pub_type: 杂志文章

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    更新日期:1988-12-01 00:00:00

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    pub_type: 杂志文章

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    journal_title:Transplantation

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    pub_type: 杂志文章

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    pub_type: 杂志文章

    doi:10.1097/TP.0000000000003333

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    更新日期:2020-05-25 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/TP.0000000000002616

    authors: Gorgen A,Rosales R,Sadler E,Beecroft R,Knox J,Dawson LA,Ghanekar A,Grant D,Greig PD,Sapisochin G

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

    doi:10.1097/TP.0000000000001037

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    pub_type: 杂志文章

    doi:

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    pub_type: 杂志文章,多中心研究

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    更新日期:2007-12-27 00:00:00

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