Inflammation-associated Graft Loss in Renal Transplant Recipients.
Dahle D, Mjoen G, et al.Nephrology Dialysis Transplantation, 26(11): 3756-3761, 2011.
Aims
To investigate the role of inflammatory biomarkers on progressive graft dysfunction and graft failure in renal transplant recipients.
Interventions
Fluvastatin 40–80 mg daily versus matching placebo. All patients received immunosuppressive therapy with ciclosporin.
Participants
2102 renal transplant recipients with stable graft function who were transplanted at least 6 months before the study.
Outcomes
Death censored graft loss, graft loss or death; other laboratory parameters included level of lipids, creatinine, creatine kinase and liver enzymes; the inflammation markers included high-sensitivity C-reactive protein (CRP) and interleukin-6 (IL-6).
Follow-up
Mean duration of 6.7 years
CET Conclusions
In this long term follow-up of the ALERT trial, high sensitivity C-reactive protein and interleukin-6 were independently associated with death censored graft loss and hence these markers of inflammation appear to be associated with long term graft outcome in recipients of a renal transplant. However it should be noted that there was only one measurement at the baseline for both CRP and IL-6. The authors also point out that results are not striking enough to be of prognostic value for individual renal transplant recipients.
Data analysis
Strict intention-to-treat analysis
Quality notes
This is a post hoc analysis of a previous publication of the same RCT: Holdaas H, Fellstrom B, Jardine AG et al. Effect of fluvastatin on cardiac outcomes in renal transplant recipients: a multicentre, randomised, placebo-controlled trial. Lancet 2003; 361: 2024–2031. The methodological quality assessment was based on the previous publication.
Trial registration
Not reported