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Long-term graft function changes in kidney transplant recipients.

Marcén R, Morales JM, Fernández-Rodriguez A, Capdevila L, Pallardó L, Plaza JJ, Cubero JJ, Puig JM, Sanchez-Fructuoso A, Arias M, Alperovich G, Serón D - NDT Plus (2010)

Bottom Line: Cyclosporine-based immunosuppression had a less favourable effect on the rates of change in allograft function.Conclusions.Poor graft function was not associated with an increased rate of decline of allograft function.Immunosuppression with cyclosporine displayed the worst declining GFR rate.

View Article: PubMed Central - PubMed

ABSTRACT
Background. Monitoring changes in glomerular filtration rate (GFR) is the recommended method for assessing the progression of kidney disease. The aim of this study was to assess the decline of graft function defined by the annualized change in GFR and the factors which affect it.Methods. Four thousand four hundred and eighty-eight patients, transplanted during the years 1990, 1994, 1998 and 2002 in 34 centres in Spain with allograft survival of at least 1 year, were included in the study. GFR was estimated using the four-variable equation of the Modification of Diet in Renal Diseases (MDRD) study. Linear mixed effects model was applied to determine the relation between the covariates and the annualized change in GFR after transplantation.Results. The average GFR at 12 months was 51.4 +/- 18.9 mL/min/1.73 m(2); most patients were in stage 3 of chronic kidney disease classification. The average patient slope, calculated in a linear model with varying-intercept and varying-slope without covariates, was -1.12 +/- 0.05 mL/min/year (slope +/- standard error). Some variables were related to both the 12-month GFR (intercept) and the slope: recipient gender, hepatitis C virus (HCV) status, estimated GFR (eGFR) at 3 months and proteinuria at 12 months. Some variables were only related to the slope of eGFR: time on dialysis, primary renal disease and immunosuppression. Others affected only the 12-month GFR: donor age, delayed graft function, acute rejection and systolic blood pressure at 12 months. Higher graft function at 3 months had a negative impact on the GFR slope. Cyclosporine-based immunosuppression had a less favourable effect on the rates of change in allograft function.Conclusions. There was a slow decline in GFR. Poor graft function was not associated with an increased rate of decline of allograft function. Immunosuppression with cyclosporine displayed the worst declining GFR rate.

No MeSH data available.


Related in: MedlinePlus

(A) Distribution of GFR slope. (B) The figure illustrates the median of the slopes, the interquartile range and the maximum and minimum values.
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fig2: (A) Distribution of GFR slope. (B) The figure illustrates the median of the slopes, the interquartile range and the maximum and minimum values.

Mentions: The eGFR rate declined from 12 months to last visit, with a mean of −1.26 ± 6.24 mL/min/year (mean ± standard deviation) and median of −0.752 mL/min (range from −68.7 to 39.1 mL/min/year) when we determined the slope by applying the least squares regression for each patient. If we used the linear mixed effects models, varying intercept and slope for each patient, the decline was −1.12 ± 0.05 mL/min/1.73 m2 per year (coefficient ± standard error) (Figure 2).


Long-term graft function changes in kidney transplant recipients.

Marcén R, Morales JM, Fernández-Rodriguez A, Capdevila L, Pallardó L, Plaza JJ, Cubero JJ, Puig JM, Sanchez-Fructuoso A, Arias M, Alperovich G, Serón D - NDT Plus (2010)

(A) Distribution of GFR slope. (B) The figure illustrates the median of the slopes, the interquartile range and the maximum and minimum values.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2875040&req=5

fig2: (A) Distribution of GFR slope. (B) The figure illustrates the median of the slopes, the interquartile range and the maximum and minimum values.
Mentions: The eGFR rate declined from 12 months to last visit, with a mean of −1.26 ± 6.24 mL/min/year (mean ± standard deviation) and median of −0.752 mL/min (range from −68.7 to 39.1 mL/min/year) when we determined the slope by applying the least squares regression for each patient. If we used the linear mixed effects models, varying intercept and slope for each patient, the decline was −1.12 ± 0.05 mL/min/1.73 m2 per year (coefficient ± standard error) (Figure 2).

Bottom Line: Cyclosporine-based immunosuppression had a less favourable effect on the rates of change in allograft function.Conclusions.Poor graft function was not associated with an increased rate of decline of allograft function.Immunosuppression with cyclosporine displayed the worst declining GFR rate.

View Article: PubMed Central - PubMed

ABSTRACT
Background. Monitoring changes in glomerular filtration rate (GFR) is the recommended method for assessing the progression of kidney disease. The aim of this study was to assess the decline of graft function defined by the annualized change in GFR and the factors which affect it.Methods. Four thousand four hundred and eighty-eight patients, transplanted during the years 1990, 1994, 1998 and 2002 in 34 centres in Spain with allograft survival of at least 1 year, were included in the study. GFR was estimated using the four-variable equation of the Modification of Diet in Renal Diseases (MDRD) study. Linear mixed effects model was applied to determine the relation between the covariates and the annualized change in GFR after transplantation.Results. The average GFR at 12 months was 51.4 +/- 18.9 mL/min/1.73 m(2); most patients were in stage 3 of chronic kidney disease classification. The average patient slope, calculated in a linear model with varying-intercept and varying-slope without covariates, was -1.12 +/- 0.05 mL/min/year (slope +/- standard error). Some variables were related to both the 12-month GFR (intercept) and the slope: recipient gender, hepatitis C virus (HCV) status, estimated GFR (eGFR) at 3 months and proteinuria at 12 months. Some variables were only related to the slope of eGFR: time on dialysis, primary renal disease and immunosuppression. Others affected only the 12-month GFR: donor age, delayed graft function, acute rejection and systolic blood pressure at 12 months. Higher graft function at 3 months had a negative impact on the GFR slope. Cyclosporine-based immunosuppression had a less favourable effect on the rates of change in allograft function.Conclusions. There was a slow decline in GFR. Poor graft function was not associated with an increased rate of decline of allograft function. Immunosuppression with cyclosporine displayed the worst declining GFR rate.

No MeSH data available.


Related in: MedlinePlus