Renin-Angiotensin-Aldosterone system inhibitors and statins prolong graft survival in post-transplant

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A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
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A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis

Published on: October 26, 2020

Joanna Pazik1, Joanna Ostrowska, Zbigniew Lewandowski

  • 1Department of Transplantation Medicine and Nephrology, Transplantation Institute, Medical University of Warsaw, Warsaw, Poland.

Annals of Transplantation
|November 27, 2008
PubMed

Insights

Statins and renin-angiotensin-system blockers significantly improve kidney transplant survival in patients with post-transplant glomerulonephritis. These safe medications should be routinely considered to reduce graft loss.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Pharmacology

Background:

  • Post-transplant glomerulonephritis is a common cause of late kidney allograft loss.
  • Current immunosuppressives do not effectively prevent or treat this condition.
  • Data on ACE inhibitors/ARBs and statins in kidney transplant survival are conflicting.

Purpose of the Study:

  • To evaluate the efficacy of therapeutic interventions for post-transplant glomerulonephritis.
  • To assess the impact of specific drug classes on kidney graft survival.

Main Methods:

  • Analysis of graft survival in 75 patients with biopsy-confirmed post-transplant glomerulonephritis.
  • Kaplan-Meier estimator, log-rank, and Wilcoxon tests were used for survival analysis.
  • Hazard ratios (HR) were calculated to determine the effect of treatments on graft loss (p<0.05).

Main Results:

  • Immunosuppression modifications did not prolong graft survival.
  • Statins reduced graft loss risk (HR=0.37, p<0.02).
  • Renin-angiotensin-system blockers (RAASB) reduced graft loss risk (HR=0.39, p<0.05).
  • Combined statin and RAASB treatment yielded the best outcome (HR=0.24, p=0.008).

Conclusions:

  • Statins and RAASB significantly prolong graft survival in post-transplant glomerulonephritis.
  • These agents are relatively safe and offer additional benefits.
  • Routine application of statins and RAASB is recommended for patients with post-transplant glomerulonephritis.
Abstract

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