Linked Life Data

19715914

Source:http://linkedlifedata.com/resource/pubmed/id/19715914

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2009-8-31
pubmed:abstractText
Renal transplant recipients show an increased risk of cardiovascular disease compared with a nontransplant population. Herein we have shown an analysis of a randomized controlled trial wherein 525 patients receiving a first or second (9.7%) renal allograft from a deceased (89.1%), a living-related (7.8%), or a living-unrelated donor (3.1%) received sirolimus (SRL), cyclosporine (CsA), and steroids (ST) at the time of transplantation with randomization at 3 months after transplantation of 430 eligible patients to continue on SRL-CsA-ST or to have CsA withdrawn with increased SRL trough targets (SRL-ST group). Graft survival, patient survival, and renal function at 5 years were analyzed by average fasting total cholesterol (<or=200 or >200 mg/dL) and triglyceride (<or=240 or >240 mg/dL) subgroups. At 5 years, total, high-density lipoprotein (HDL), and low-density lipoprotein [LDL] cholesterol and triglyceride values were similar between the groups. Statins ( approximately 80% of patients of both groups) were most effective to lower cholesterol ( approximately 50 mg/dL; P < .001; both groups), and fibrates ( approximately 25% of patients of both groups) were most effective to decrease triglycerides ( approximately 100 mg/dL; P < .001; both groups). Renal function and blood pressure were significantly better with SRL-ST. Hypercholesterolemia and hypertriglyceridemia were associated with reduced graft survival, patient survival, and calculated GFR, but the only significant difference was lower graft survival among SRL-CsA-ST patients with hypertriglyceridemia. Cardiovascular-related deaths were reported in 3.7% and 2.8% of patients in the SRL-CsA-ST and SRL-ST groups, respectively. In conclusion, when compared with continuous SRL-CsA-ST, CsA withdrawal at 3 months followed by SRL-ST significantly improved glomerular filtration rate (GFR) and blood pressure without a further increase in lipid parameters or an incidence of untoward effects from hyperlipidemia, despite a 2-fold higher SRL exposure.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:issn
1873-2623
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
41
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2339-44
pubmed:meshHeading
pubmed-meshheading:19715914-Adolescent, pubmed-meshheading:19715914-Adult, pubmed-meshheading:19715914-Australia, pubmed-meshheading:19715914-Blood Pressure, pubmed-meshheading:19715914-Canada, pubmed-meshheading:19715914-Cholesterol, HDL, pubmed-meshheading:19715914-Cholesterol, LDL, pubmed-meshheading:19715914-Cyclosporine, pubmed-meshheading:19715914-Dose-Response Relationship, Drug, pubmed-meshheading:19715914-Drug Administration Schedule, pubmed-meshheading:19715914-Drug Therapy, Combination, pubmed-meshheading:19715914-Europe, pubmed-meshheading:19715914-Humans, pubmed-meshheading:19715914-Immunosuppressive Agents, pubmed-meshheading:19715914-Kidney Transplantation, pubmed-meshheading:19715914-Lipids, pubmed-meshheading:19715914-Patient Selection, pubmed-meshheading:19715914-Research Design, pubmed-meshheading:19715914-Retrospective Studies, pubmed-meshheading:19715914-Sirolimus, pubmed-meshheading:19715914-Treatment Outcome, pubmed-meshheading:19715914-Triglycerides, pubmed-meshheading:19715914-Young Adult
pubmed:articleTitle
Similar lipid profile but improved long-term outcomes with sirolimus after cyclosporine withdrawal compared to sirolimus with continuous cyclosporine.
pubmed:affiliation
Hospital 12 de Octubre, Madrid, Spain. jmorales@h12o.es
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't, Multicenter Study