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Comparative effects of sirolimus and mycophenolate mofetil on erythropoiesis in kidney transplant patients.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2004 Dec; Vol. 4 (12), pp. 2001-6. - Publication Year :
- 2004
-
Abstract
- Anemia and erythrocytosis (PTE) are common after kidney transplantation. We sought to determine the influence of sirolimus compared to mycophenolate mofetil (MMF) on post-transplant erythropoiesis. A total of 214 patients with recent kidney or kidney-pancreas transplants were treated with either sirolimus-based (n = 87) or MMF-based (n = 127) therapy. At 12 months, the prevalence of anemia was 31% with MMF and 57% with sirolimus (p < 0.001). Linear regression was used to examine the independent influence of sirolimus on hemoglobin at 12 months, controlling for multiple factors including gender and renal function. Sirolimus remained a significant correlate of lower hemoglobin in all patients (slope =-1.060, 95% CI: -1.76 to -0.362, p = 0.003), and in patients without PTE (slope =-0.671, 95% CI: -1.32 to -0.028, p = 0.041). PTE, defined as a persistent hematocrit above 51%, occurred in 19% with MMF and 7% with sirolimus (p = 0.013). PTE was examined using logistic regression analysis. Sirolimus use correlated negatively with PTE (odds ratio with sirolimus = 0.33, 95% CI: 0.12 to 0.89, p = 0.028). Our results indicate that, compared to treatment with MMF, treatment of kidney or kidney-pancreas recipients with sirolimus is associated with a higher prevalence of anemia, lower hemoglobin levels and lower incidence of PTE.
- Subjects :
- Anemia prevention & control
Female
Graft Rejection epidemiology
Hematocrit
Hemoglobins metabolism
Humans
Kidney Function Tests
Kidney Transplantation immunology
Living Donors
Male
Middle Aged
Racial Groups
Tissue Donors
Anemia etiology
Erythropoiesis drug effects
Immunosuppressive Agents therapeutic use
Kidney Transplantation adverse effects
Kidney Transplantation physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6135
- Volume :
- 4
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 15575902
- Full Text :
- https://doi.org/10.1111/j.1600-6143.2004.00612.x