Подходы к коррекции иммуносупрессивной терапии при хронической нефротоксичности ингибиторов кальцинейрина
https://doi.org/10.23873/2074-0506-2012-0-3-26-32
Аннотация
Дан анализ эффективности и безопасности двух возможных подходов к коррекции дозы циклоспорина у пациентов с дисфункцией трансплантированной почки, обусловленной нефротоксическим действием CNI. Установлено, что основной причиной отмены эверолимуса является протеинурия нефротического уровня, развившаяся у 19 % пациентов.
Об авторах
Е. С. СтоляревичРоссия
кафедра нефрологии
Екатерина Столяревич
И. Г. Ким
Россия
Л. Ю. Артюхина
Россия
Л. Г. Куренкова
Россия
Н. Д. Федорова
Россия
Н. А. Томилина
Россия
кафедра нефрологии
Список литературы
1. Клиническая трансплантация почки: нефрологические аспекты, роль в заместительной терапии терминальной ХПН // Очерки клинической трансплантологии / под ред. С. В. Готье. – М.: Триада, 2009. – С. 107–175.
2. Столяревич, Е. С. Поздняя дисфункция трансплантированной почки: причины, морфологическая характеристика, подходы к профилактике и лечению / Е. С. Столяревич, Н.А. Томилина // Вестник трансплантологии и искусственных органов. – 2009. – Т. 11, №3. – с. 114–122.
3. Хроническая нефротоксичность циклоспорина А: функционально-морфологичевская характеристика и клинические проявления в поздние сроки после трансплантации почки / А. В. Суханов [и др.] // Нефрология и диализ. – 2004. – №2. –С. 170–177.
4. Conversion to sirolimus for chronic renal allograft dysfunction: risk factor for graft loss and severe side effects / D. Abramovwicz [et al.] // Nephrol. Dial. Transplan. – 2008. – №23. – Р. 3727–3729.
5. Low-dose mycophenolate mofetil is an effective and safe treatment to permit phased reduction in calcineurin inhibitors in chronic allograft nephropathy / B. Afzali [et al.] // Transplant. – 2005. – №3. – Р. 304–309.
6. Synergistic effects of cyclosporine and rapamycin in a chronic nephrotoxicity model / T. F. Andoh [et al.] // Transplant. – 1996. – №3. – Р. 311–316.
7. Conversion to sirolimus from cyclosporine may induce nephrotic proteinuria and progressive deterioration of renal function in chronic allograft nephropathy patients / M. Boratyńska [et al.] // Transplant. Proc. – 2006. – №38. – Р. 101–104.
8. Everolimus and long-term outcomes in renal transplantation / J.M. Campist ol [et al.] // Transplant. – 2011. – № 3. – S. 3 – 25.
9. Excellent long-term results in de novo renal transplant recipients treated with proliferation signal inhibitors and reduced calcineurin inhibitors exposure / M. Carmellini [et al.] // Transplant. Proc. – 2008. – №40 (6). – Р. 1858–1861.
10. Chiurchiu, C. Thrombotic microangiopathy in renal transplantation / C. Chiurchiu, P. Ruggenenti G. Remuzzi // Ann. Transplant. – 2002. – №7 (1). – Р. 28–33.
11. Colvin, R. B. Renal transplant pathology // Heptinstall’s Pathology of the Kidney / R. B. Colvin; ed. by J. C. Jennette [et al.]. – 5th Ed. – Philadelphia: Lippincott-Raven Publishers, 1998. – Р. 1409–1540.
12. Impact of cyclosporine reduction with MMF: a randomized trial in chronic allograft dysfunction. The ‘reference’study / L. Frimat [et al.] // Am. J. Transplant. – 2006. – №11. – Р. 2725– 2734.
13. Conversion therapy to everolimus in renal transplant recipients: results after one year / F. Giron [et al.] // Transplant. Proc. – 2008. – №40 (3). – Р. 711–713.
14. Randomized controlled study comparing reduced calcineurin inhibitors exposure versus standard cyclosporinebased immunosuppression / D. Hern ández // Transplant. – 2007. – №6. – Р. 706–714.
15. Early, abrupt conversion of de novo renal transplant patients from cyclosporine to everolimus: results of a pilot study / H. Holdaas [et al.] // Clin. Transplant. – 2008. – №3. – Р. 366–371.
16. On behalf of the ASCERTAIN Investigators11 Conversion of LongTerm Kidney Transplant Recipients from Calcineurin Inhibitor Therapy to Everolimus: A Randomized, Multicenter, 24–Month Study / Н. Holdaas [et al.] // Transplant. – 2011. – Vol. 27; 92 (4). – Р. 410–418.
17. Synergistic interactions of cyclosporine and rapamycin to inhibit immune performances of normal human peripheral blood lymphocytes in vitro / B. D. Kahan [et al.] // Transplant. – №1. – Р. 232–239.
18. Efficacy on renal function of early conversion from Cyclosporine to Sirolimus 3 months after renal transplantation: Concept study / Y. Lebranchu
19. Proteinuria following a switch from calcineurin inhibitors to sirolimus / E. Letavernier [et al.] // Transplant. – 2005. – №9. – Р. 1198– 1203.
20. T r e a t m e n t o f c a l c i n e u r i n inhibitor toxicity by dose reduction plus introduction of mycophenolate mofetil / W. McKane [et al.] // Transplant. Proc. – 2001. –№ 33. – Р. 1224–1225.
21. Cyclosporin A nephropathy: Standartization of the evaluation of kidney biopsies / M.J. Mihatsch [et al.] // Clin. Nephrol. – 1994. –№41. – Р. 23–32.
22. Calcineurin inhibitor sparing with mycophenolate in kidney transplantation: a systematic review and meta-analysis / J. Moore [et al.] // Transplant. –2009. – №4. – Р. 591–605.
23. Conversion from a calcineurin inhibitorbased immunosuppressive regimen to everolimus in renal transplant recipients: effect on renal function and proteinuria / J. Morales [et al.] // Transplant. Proc. – 2007. – №39 (3). – Р. 591–593.
24. Studies on morphological outcome of cyclosporine-associated arteriolopathy after discontinuation of cyclosporine in renal allografts / K. Morozumi [et al.] // Clin. Nephrol. – 1992. – №1. – Р. 1–8.
25. Long-term improvement in renal function after cyclosporine reduction in renal transplant recipients with histologically proven chronic cyclosporine nephropathy / G. Mourad [et al.] // Transplant. –1998. – №5. –Р. 661–667.
26. Calcineurin inhibitor nephrotoxicity: longitudinal assessment by protocol histology / B. J. Nankivell [et al.] // Transplant. –2004. – №4. – Р. 557–565.
27. The natural history of chronic allograft nephropathy / B. J. Nankivell [et al.] // N. Engl. J. Med. – 2003. – №349. – Р. 2326–2334.
28. Everolimus and reduced exposure cyclosporine in de novo renaltransplant recipients: a threeyear phase II, randomized, multicenter, open-label study / B. Nashan [et al.] // Transplant. – 2004. – №9. – Р. 1332– 1340.
29. Calcineurin inhibitor reduction based on maintenance immunosuppression with mycophenolate mofetil in renal transplant patients: POP study / L.M. Pallardó [et al.] // Transplant. Proc. – 2007. – №39 (7). – Р. 2187–2189.
30. Efficacy and safety of 2 doses of everolimus combined with reduced dose Neoral in de novo kidney transplant recipients: 24 months analysis / J. Pascual [et al.] // Am. J. Transplant. – 2005. – №. 5 (Suppl 11). – Р. 1010.
31. Pascual, J. Concentration-controlled everolimus (Certican): combination with reduced dose calcineurin inhibitors / J. Pascual // Transplant. –2005. – №9 (Suppl.). – Р. 76–79.
32. Pilmore, H.L. Calcineurin inhibitor nephrotoxicity: reduction in dose results in marked improvement in renal function in patients with coexisting chronic allograft nephropathy / H. L. Pilmore, I. D Dittmer // Clin. Transplant. – 2002. – №3. –Р. 191–195.
33. Ponticelli, C.De novo thrombotic microangiopathy. An underrated complication of renal transplantation / C. Ponticelli // Clinical Nephrology. – 2007. – №6. – Р. 335–340.
34. Ruggenenti, P. Post-transplant hemolytic-uremic syndrome / P. Ruggenenti // Kidney international. – 2002. – N 62. – P. 1093–1104.
35. Evolution of proteinuria after conversion from calcineurin inhibitors (CNI) to sirolimus (SRL) in renal transplant patients: a multicenter study / J.C. Ruiz [et al.] // Transplant. Proc. – 2005. – №9. – Р. 3833–3835.
36. Use of the new proliferation signal inhibitor everolimus in renal transplant patients in Spain: preliminary results of the EVERODATA registry / J.C. Ruiz [et al.] // Transplant. Proc. – 2007. – №7. – Р. 2157–2159.
37. Increase of proteinuria after conversion from calcineurin inhibitor to sirolimus-based treatment in kidney transplant patients with chronic allograft dysfunction / J.C. Ruiz // Nephrol. Dial. Transplant. – 2006. – №11. –Р. 3252– 3257 (46).
38. Evaluation of the efficacy and safety of the conversion from a calcineurin inhibitor to an everolimus-based therapy in maintenance renal transplant patients / A. Sánchez Fructuoso [et al.] // Transplant. Proc. – 2007. – №3 9 (7). – Р. 2148–2150.
39. Conversion from calcineurin inhibitors to sirolimus maintenance therapy in renal allograft recipients: 24– month efficacy and safety results from the CONVERT trial / F.P. Schena [et al.] // Transplantation. – 2009. – №2. – Р. 233–242.
40. Reproducibility studies on arteriolar hyaline thickening scoring in calcineurin inhibitor-treated renal allograft recipients / B. Sis [et al.] // Am. J. Transplant. – 2006. – №6. – Р. 1444–1450.
41. Cyclosporin A toxicity of the renal allograft–a late complication and potentially reversible / C. Sommerer [et al.] // Nephron. – 2002. – №2. – Р. 339–345.
42. A randomized controlled trial of immunosuppression conversion for the treatment of chronic allograft nephropathy / J. Stoves [et al.] // Nephrol. Dial. Transplant. – 2004. – №19. – Р. 2113–2120.
43. 12-month safety and efficacy of everolimus with reduced exposure cyclosporine in de novo renal transplant recipients / H. Tedesco-Silva [et al.] // Transplant. Int. – 2007. – №1. – Р. 27–36.
44. A novel approach to the treatment of chronic allograft nephropathy / M.R. Weir [et al.] // Transplant. – 1997. – №12. –Р. 1706–1710.
45. Cyclosporine-associated thrombotic microangiopathy in renal allografts / A. Zarifian [et al.] // Kidney Int. – 1999. – №6. – Р. 2457–2466.
46. Cyclosporin-induced endothelial cell injury / C. Zoja [et al.] // Lab. Invest. – 1986. – №55. – Р. 455–462.
Рецензия
Для цитирования:
Столяревич Е.С., Ким И.Г., Артюхина Л.Ю., Куренкова Л.Г., Федорова Н.Д., Томилина Н.А. Подходы к коррекции иммуносупрессивной терапии при хронической нефротоксичности ингибиторов кальцинейрина. Трансплантология. 2012;(3):26-32. https://doi.org/10.23873/2074-0506-2012-0-3-26-32
For citation:
Stolyarevich E.S., Kim J.G., Artyukhina L.Yu., Kurenkova L.G., Fedorova N.D., Tomilin N.A. Approaches to correction of immunosuppressive therapy in chronic nephrotoxicity of calcineurin inhibitors. Transplantologiya. The Russian Journal of Transplantation. 2012;(3):26-32. (In Russ.) https://doi.org/10.23873/2074-0506-2012-0-3-26-32