Effect of mycophenolate mofetil on progression of interstitial fibrosis and tubular atrophy after kidney transplantation: a retrospective study

Mihovilović, Karlo and Maksimović, Bojana and Kocman, Branislav and Guštin, Denis and Vidas, Željko and Bulimbašić, Stela and Galešić Ljubanović, Danica and Sabljar Matovinović, Mirjana and Knotek, Mladen (2014) Effect of mycophenolate mofetil on progression of interstitial fibrosis and tubular atrophy after kidney transplantation: a retrospective study. BMJ Open, 4 (7). e005005. ISSN 2044-6055

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OBJECTIVES: Chronic transplant dysfunction after kidney transplantation is a major reason of kidney graft loss and is caused by immunological and non-immunological factors. There is evidence that mycophenolate mofetil (MMF) may exert a positive effect on renal damage in addition to immunosuppression, by its direct antifibrotic properties. The aim of our study was to retrospectively investigate the role of MMF doses on progression of chronic allograft dysfunction and fibrosis and tubular atrophy (IF/TA). ----- SETTING: Retrospective, cohort study. ----- PARTICIPANTS: Patients with kidney transplant in a tertiary care institution. This is a retrospective cohort study that included 79 patients with kidney and kidney-pancreas transplantation. Immunosuppression consisted of anti-interleukin 2 antibody induction, MMF, a calcineurin inhibitor±steroids. ----- PRIMARY OUTCOME MEASURES: An association of average MMF doses over 1 year post-transplant with progression of interstitial fibrosis (Δci), tubular atrophy (Δct) and estimated-creatinine clearance (eCrcl) at 1 year post-transplant was evaluated using univariate and multivariate analyses. ----- RESULTS: A higher average MMF dose was significantly independently associated with better eCrcl at 1 year post-transplant (b=0.21±0.1, p=0.04). In multiple regression analysis lower Δci (b=-0.2±0.09, p=0.05) and Δct (b=-0.29±0.1, p=0.02) were independently associated with a greater average MMF dose. There was no correlation between average MMF doses and incidence of acute rejection (p=0.68). ----- CONCLUSIONS: A higher average MMF dose over 1 year is associated with better renal function and slower progression of IF/TA, at least partly independent of its immunosuppressive effects.

Item Type: Article
Additional Information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work noncommercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0.
MeSH: Adult ; Atrophy / prevention & control ; Cohort Studies ; Disease Progression ; Female ; Fibrosis / prevention & control ; Humans ; Immunosuppressive Agents / administration & dosage ; Kidney / pathology ; Kidney Transplantation ; Kidney Tubules / pathology ; Male ; Mycophenolic Acid / administration & dosage ; Mycophenolic Acid / analogs & derivatives* ; Postoperative Complications / prevention & control ; Retrospective Studies
Departments: Katedra za internu medicinu
Katedra za patologiju
Depositing User: Marijan Šember
Status: Published
Mihovilović, KarloUNSPECIFIED
Maksimović, BojanaUNSPECIFIED
Kocman, BranislavUNSPECIFIED
Bulimbašić, StelaUNSPECIFIED
Galešić Ljubanović, DanicaUNSPECIFIED
Sabljar Matovinović, MirjanaUNSPECIFIED
Date: 3 July 2014
Date Deposited: 24 Feb 2016 11:47
Last Modified: 17 Jul 2020 09:11
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2496

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