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Effect of sirolimus on left ventricular hypertrophy in kidney transplant recipients: a 1-year nonrandomized controlled trial.
Am J Kidney Dis. 2008 Aug; 52(2):324-30.AJ

Abstract

BACKGROUND

Left ventricular hypertrophy (LVH) after renal transplantation may be affected by immunosuppressive therapy.

STUDY DESIGN

Nonrandomized controlled trial evaluating the effect of sirolimus (SRL) on LVH of renal transplant recipients (RTRs).

SETTING & PARTICIPANTS

13 RTRs without diabetes who had received a single-kidney transplant from a deceased donor with chronic allograft dysfunction and biopsy-proven allograft nephropathy who were converted from calcineurin-inhibitor (CNI) to SRL treatment; 26 controls matched for age and year of transplantation who were not converted from CNI to SRL treatment.

INTERVENTION

Conversion from CNI to SRL therapy.

OUTCOMES & MEASUREMENTS

Left ventricular mass determination by using echocardiography at baseline and again 1 year later. Blood pressure (BP), hemoglobin level, serum creatinine level, uric acid level, lipid levels, trough levels of immunosuppressive drugs, and daily proteinuria were assessed at least twice monthly. Conventional antihypertensive therapy was used to achieve BP of 130/80 mm Hg or less.

RESULTS

The study population included 26 men and 13 women (age, 25 to 66 years). Changes in BP were similar in the 2 groups (between-group difference, -4 +/- 5 mm Hg; P = 0.5 for systolic BP; -2 +/- 3; P = 0.6 for diastolic BP), whereas left ventricular mass significantly decreased in the SRL group alone (between-group difference, 8.6 +/- 2.4 g/m(2.7); P < 0.001) because of a decrease in both the interventricular septum and left ventricular posterior wall. LVH regressed in 12 of 13 patients on SRL therapy and 10 of 26 controls (P = 0.002).

LIMITATIONS

Nonrandomized design. Single-center study with small sample size.

CONCLUSIONS

Conversion from CNI to SRL therapy may regress LVH in RTRs regardless of BP changes, mainly by decreasing left ventricular wall thickness, thus suggesting nonhemodynamic-effect mechanisms of SRL on left ventricular mass.

Authors+Show Affiliations

Divisione di Nefrologia, Dialisi, e Trapianto, Azienda Ospedaliera Universitaria S Martino, Genova, Italy. ernesto.paoletti@hsanmartino.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Controlled Clinical Trial
Journal Article

Language

eng

PubMed ID

18585837

Citation

Paoletti, Ernesto, et al. "Effect of Sirolimus On Left Ventricular Hypertrophy in Kidney Transplant Recipients: a 1-year Nonrandomized Controlled Trial." American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, vol. 52, no. 2, 2008, pp. 324-30.
Paoletti E, Amidone M, Cassottana P, et al. Effect of sirolimus on left ventricular hypertrophy in kidney transplant recipients: a 1-year nonrandomized controlled trial. Am J Kidney Dis. 2008;52(2):324-30.
Paoletti, E., Amidone, M., Cassottana, P., Gherzi, M., Marsano, L., & Cannella, G. (2008). Effect of sirolimus on left ventricular hypertrophy in kidney transplant recipients: a 1-year nonrandomized controlled trial. American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation, 52(2), 324-30. https://doi.org/10.1053/j.ajkd.2008.04.018
Paoletti E, et al. Effect of Sirolimus On Left Ventricular Hypertrophy in Kidney Transplant Recipients: a 1-year Nonrandomized Controlled Trial. Am J Kidney Dis. 2008;52(2):324-30. PubMed PMID: 18585837.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of sirolimus on left ventricular hypertrophy in kidney transplant recipients: a 1-year nonrandomized controlled trial. AU - Paoletti,Ernesto, AU - Amidone,Marco, AU - Cassottana,Paolo, AU - Gherzi,Maurizio, AU - Marsano,Luigina, AU - Cannella,Giuseppe, Y1 - 2008/06/30/ PY - 2008/01/01/received PY - 2008/04/23/accepted PY - 2008/7/1/pubmed PY - 2008/8/6/medline PY - 2008/7/1/entrez SP - 324 EP - 30 JF - American journal of kidney diseases : the official journal of the National Kidney Foundation JO - Am J Kidney Dis VL - 52 IS - 2 N2 - BACKGROUND: Left ventricular hypertrophy (LVH) after renal transplantation may be affected by immunosuppressive therapy. STUDY DESIGN: Nonrandomized controlled trial evaluating the effect of sirolimus (SRL) on LVH of renal transplant recipients (RTRs). SETTING & PARTICIPANTS: 13 RTRs without diabetes who had received a single-kidney transplant from a deceased donor with chronic allograft dysfunction and biopsy-proven allograft nephropathy who were converted from calcineurin-inhibitor (CNI) to SRL treatment; 26 controls matched for age and year of transplantation who were not converted from CNI to SRL treatment. INTERVENTION: Conversion from CNI to SRL therapy. OUTCOMES & MEASUREMENTS: Left ventricular mass determination by using echocardiography at baseline and again 1 year later. Blood pressure (BP), hemoglobin level, serum creatinine level, uric acid level, lipid levels, trough levels of immunosuppressive drugs, and daily proteinuria were assessed at least twice monthly. Conventional antihypertensive therapy was used to achieve BP of 130/80 mm Hg or less. RESULTS: The study population included 26 men and 13 women (age, 25 to 66 years). Changes in BP were similar in the 2 groups (between-group difference, -4 +/- 5 mm Hg; P = 0.5 for systolic BP; -2 +/- 3; P = 0.6 for diastolic BP), whereas left ventricular mass significantly decreased in the SRL group alone (between-group difference, 8.6 +/- 2.4 g/m(2.7); P < 0.001) because of a decrease in both the interventricular septum and left ventricular posterior wall. LVH regressed in 12 of 13 patients on SRL therapy and 10 of 26 controls (P = 0.002). LIMITATIONS: Nonrandomized design. Single-center study with small sample size. CONCLUSIONS: Conversion from CNI to SRL therapy may regress LVH in RTRs regardless of BP changes, mainly by decreasing left ventricular wall thickness, thus suggesting nonhemodynamic-effect mechanisms of SRL on left ventricular mass. SN - 1523-6838 UR - https://www.unboundmedicine.com/medline/citation/18585837/Effect_of_sirolimus_on_left_ventricular_hypertrophy_in_kidney_transplant_recipients:_a_1_year_nonrandomized_controlled_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0272-6386(08)00866-4 DB - PRIME DP - Unbound Medicine ER -