The effect of everolimus versus mycophenolate upon proteinuria following kidney transplant and relationship to graft outcomes.
Wiseman AC, McCague K, et al.American Journal of Transplantation. 2013; 13(2):442-449
Aims
The aim of this post hoc analysis of proteinuria incidence and relationship to graft function and survival was performed using data from a multicenter, randomized prospective trial.
Interventions
Everolimus 1.5 mg/day (target trough concentration 3–8 ng/mL) with low-dose CsA versus everolimus 3.0 mg/day (target trough concentrations 6–12 ng/mL) with low-dose CsA versus standard CsA and mycophenolic acid.
Participants
From the initial cohort of 833 patients, only the 726 patients in whom urine protein/creatinine ratios could be calculated at month 3 were included in the analysis.
Outcomes
Rates of proteinuria, glomerular filtration rate, urinary protein/creatinine ratio, graft loss.
Follow-up
24 months
CET Conclusions
In this post hoc study there was an association between proteinuria and the dose of everolimus used. Also proteinuria greater than or equal to 300mg/g at 3 months post transplant was associated with a lower eGFR and graft survival at 2 years, but independent of the sirolimus dose.
Data analysis
Strict intention-to-treat analysis
Quality notes
Score based on Tedesco Silva Jr, H., D. Cibrik, et al. (2010). "Everolimus Plus Reduced-Exposure CsA versus Mycophenolic Acid Plus Standard-Exposure CsA in Renal-Transplant Recipients." American Journal of Transplantation 10(6): 1401-1413.
Trial registration
Not reported