"Evaluation of Nephrotoxicity of De Novo Rapamune Use and Association between ESRD and Baseline Urine Albumin and Protein in Kidney-Transplant Recipients: A Longitudinal Observation Study" will be presented by Liangxing Zou, masters candidate in Biostatistics.
Refreshments will be served prior to the presentation.
In kidney-transplant recipients, conversion to rapamune from calcineurin inhibitors (CNIs) has been used as a strategy to suppress acute rejection while maintaining low nephrotoxicity induced by CNIs. However, the toxicity of de novo rapamune use on renal grafts has not been well studied. In this study of 153 kidney-transplant recipients, mixed linear models were used to address this question, with rapamune usage, visit number and their interaction as fixed effects, plus adjusters. When rapamune usage was coded for subjects who never took rapamune versus subjects who took at least some rapamune, F tests found non-significant interactions between rapamune use and visit in models of different responses (urine protein: p = 0.47; urine albumin: p = 0.85; diastolic blood pressure: p = 0.63; systolic blood pressure: p = 0.67) except GFR (p = 0.005). Also, rapamune use had no significant main effect on these responses (P > 0.20 for all outcomes). When rapamune usage was coded for subjects who never took rapamune , subjects who took some rapamune, or subjects who always took rapamune, or coded for individual visits (i.e., rapamune usage was a time-dependent covariate for each subject), similar results were obtained. We also tested whether baseline urine albumin is an effective predictor of end-stage renal disease (ESRD). Both Kaplan-Meier analysis (with subjects split at the median) and Cox regression showed that the ESRD hazard was higher for higher baseline urine albumin after adjusted for covariates. Thus, we conclude that 1) De novo rapamune use has nephrotoxicity comparable to tacrolimus; and 2) baseline urine albumin is a significant predictor of ESRD in kidney-transplant recipients.
|Tue Apr 17, 2012 2pm – 3pm GMT (no daylight saving)|
|Mayo Memorial Building, Minneapolis, MN (map)|