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ISSN 2007-6800 (Print)

2017, Number 2

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Rev Mex Traspl 2017; 6 (2)

Association between changes by calcineurin inhibitors in protocol biopsies and the kidney allograft function

Gil-Romero D, Jalomo-Martínez B, Gómez-Navarro B

Language: Spanish
References: 27
Page: 45-52
PDF size: 258.61 Kb.


ABSTRACT

Introduction: With the advent of calcineurin inhibitors (ICN) the kidney allograft over life was improved. One of the main problems the use of these drugs is the nephrotoxicity. The aim of this study is compare the kidney allograft function in a year with patients with histological diagnosis of changes by ICN in protocol biopsy. Material and methods: Patients of the UMAE HE-CMNO were included in a longitudinal, retrospective, observational design, with kidney transplant from January 1st of 2009 to 30 June 2012. Patients were included in two cohorts, the cohort of study (CICN) with histologic diagnosis of changes by ICN and a cohort control (CN) with normal histological diagnosis in protocol biopsies within the first six months of transplant. The end point was analyze the function of the kidney graft in a year. As secondary points it was determinate the incidence of clinical reject and the allograft dysfunction in a year. Results: 91 patients were included from which 39 patients in the CICN and 52 in the CN. Regarding the demographic characteristics it was observed a significance between the CICN and the CN at the intermediate risk CMV (59% vs. 86% p = 0.003) and high risk CMV (31% vs. 8% p = 0.005) respectively. The kidney allograft function during the first year didn’t show significance between the cohorts, and did show significance in the intragroup regarding the basal creatinine levels and the finals in the CN (1.01 ± 0.28 vs. 1.18 ± 0.47 mg/dL p = 0.021), against CICN (1.06 ± 0.21 vs. 1.12 ± 1.30 mg/dL p = 0.143) and in the estimation of the glomerular filtration rate by MDRD in CN (88.9 ± 20.9 vs. 77.2 ± 17.6 mL/min/1.73 m2 SC p = 0.004), versus CICN (85.5 ± 16.4 vs. 83.1 ± 17.9 mL/min/1.73 m2 SC p = 0.356). The incidence of clinical reject was 8% without differential significance between the cohorts, the same as the allograft dysfunction a year with 16% incidence. Conclusions: Kidney graft function doesn’t show differential significance between the cohorts, with tendency to preserve the function in patients with histological changes by ICN, there was no difference in the incidence of rejection, nor allograft dysfunction. So it can be considered the toxicity by ICN it does not influence negatively in the kidney allograft function.


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