Efficacy of the program of rapamycin combined with CNI in chronic allograft nephropathy
10.3760/cma.j.issn.0254-1785.2012.01.006
- VernacularTitle:西罗莫司与钙调磷酸酶抑制剂联合方案在慢性移植肾肾病中的应用
- Author:
Junqi GUO
;
Heyi HU
;
Yuhua ZOU
;
Xiaowen CHEN
;
Xia GAO
;
Fuqiang HE
;
Zhiyong ZHENG
;
Weizhen WU
;
Shunliang YANG
;
Jianmin TAN
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Chronic allograft nephropathy;
Sirolimus
- From:
Chinese Journal of Organ Transplantation
2012;33(1):22-24
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the efficacy of rapamycin combined with CsA/Tacrolimus (Tac) in chronic allograft nephropathy (CAN).MethodsFifty-three cases of CAN accepted the quadruple immunosuppressive drug program,which contained rapamycin combined with CsA/Tac and MMF and prednisone,and CsA/Tac and MMF were reduced to the original amount of 25% to 50%.After treatment for 12 months,more relevant indicators,including serum creatinine,glomerular filtration rate,serum cholesterol,triglycerides,urinary protein,GPT and bilirubin and other changes were observed.ResultsIn the patients receiving quadruple regimen of rapamycin during 12 months,the blood Ccr was decreased from (161.51 ± 106.48)μmol/L before treatment to (126.51 ± 56.2)μmol/L after treatment for 6 months (P<0.05) and to (123.43 ± 54.18)μmol/L after for 12 months (P<0.01).The GFR was increased from (0.754 ± 0.302) ml/s before treatment to (0.952 ± 0.347)ml/s after treatment for 6 months (P<0.05) and to (1.007 ± 0.394) ml/s after treatment for 12 months (P<0.01).Cholesterol and triglycerides in patients had no significant change before and after treatment.The positive rate of proteinuria after treatment showed an increasing trend from 9.4% before treatment to 26.4% after treatment for 12 months.ConclusionThe quadruple program of rapamycin combined with CsA/FK506 and MMF can significantly improve Ccr and GFR in patients with CAN,but it can increase the incidence of proteinuria in patients: