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Reduced exposure to...
Reduced exposure to calcineurin inhibitors in renal transplantation.
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- Ekberg, Henrik (författare)
- Lund University,Lunds universitet,Enheten för forskning kring njurfunktion och njursjukdom,Kirurgi,Forskargrupper vid Lunds universitet,Renal Research Unit,Surgery,Lund University Research Groups
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Tedesco-Silva, Helio (författare)
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Demirbas, Alper (författare)
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Vítko, Stefan (författare)
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Nashan, Björn (författare)
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Gürkan, Alp (författare)
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Margreiter, Raimund (författare)
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Hugo, Christian (författare)
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Grinyó, Josep M (författare)
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Frei, Ulrich (författare)
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Vanrenterghem, Yves (författare)
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Daloze, Pierre (författare)
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Halloran, Philip F (författare)
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(creator_code:org_t)
- 2007
- 2007
- Engelska.
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Ingår i: New England Journal of Medicine. - 0028-4793. ; 357:25, s. 2562-2575
- Relaterad länk:
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http://www.ncbi.nlm....
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND: Immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens. METHODS: We randomly assigned 1645 renal-transplant recipients to receive standard-dose cyclosporine, mycophenolate mofetil, and corticosteroids, or daclizumab induction, mycophenolate mofetil, and corticosteroids in combination with low-dose cyclosporine, low-dose tacrolimus, or low-dose sirolimus. The primary end point was the estimated glomerular filtration rate (GFR), as calculated by the Cockcroft-Gault formula, 12 months after transplantation. Secondary end points included acute rejection and allograft survival. RESULTS: The mean calculated GFR was higher in patients receiving low-dose tacrolimus (65.4 ml per minute) than in the other three groups (range, 56.7 to 59.4 ml per minute). The rate of biopsy-proven acute rejection was lower in patients receiving low-dose tacrolimus (12.3%) than in those receiving standard-dose cyclosporine (25.8%), low-dose cyclosporine (24.0%), or low-dose sirolimus (37.2%). Allograft survival differed significantly among the four groups (P=0.02) and was highest in the low-dose tacrolimus group (94.2%), followed by the low-dose cyclosporine group (93.1%), the standard-dose cyclosporine group (89.3%), and the low-dose sirolimus group (89.3%). Serious adverse events were more common in the low-dose sirolimus group than in the other groups (53.2% vs. a range of 43.4 to 44.3%), although a similar proportion of patients in each group had at least one adverse event during treatment (86.3 to 90.5%). CONCLUSIONS: A regimen of daclizumab, mycophenolate mofetil, and corticosteroids in combination with low-dose tacrolimus may be advantageous for renal function, allograft survival, and acute rejection rates, as compared with regimens containing daclizumab induction plus either low-dose cyclosporine or low-dose sirolimus or with standard-dose cyclosporine without induction. (ClinicalTrials.gov number, NCT00231764 [ClinicalTrials.gov].).
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Nyckelord
- Adrenal Cortex Hormones: administration & dosage
- Adrenal Cortex Hormones: therapeutic use
- Antibodies
- Monoclonal: administration & dosage
- Calcineurin: antagonists & inhibitors
- Cyclosporine: administration & dosage
- Diabetes Mellitus: etiology
- Graft Rejection: prevention & control
- Enzyme Inhibitors: administration & dosage
- Immunoglobulin G: administration & dosage
- Immunosuppressive Agents: adverse effects
- Immunosuppressive Agents: administration & dosage
- Immunosuppressive Agents: therapeutic use
- Mycophenolic Acid: analogs & derivatives
- Mycophenolic Acid: administration & dosage
- Prednisone: administration & dosage
- Sirolimus: administration & dosage
- Sirolimus: adverse effects
- Tacrolimus: administration & dosage
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Ekberg, Henrik
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Tedesco-Silva, H ...
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Demirbas, Alper
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Vítko, Stefan
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Nashan, Björn
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Gürkan, Alp
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visa fler...
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Margreiter, Raim ...
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Hugo, Christian
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Grinyó, Josep M
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Frei, Ulrich
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Vanrenterghem, Y ...
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Daloze, Pierre
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Halloran, Philip ...
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visa färre...
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