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Impaired Microcirculation in Children After Kidney Transplantation: Everolimus Versus Mycophenolate Based

Stephan Ruben1, Martin Kreuzer1, Anja Büscher2

  • 1Dept. of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.

Kidney & Blood Pressure Research
|May 29, 2018
PubMed

Insights

Everolimus-based immunosuppression in pediatric kidney transplant recipients (KTx) is linked to worse microvascular function compared to standard treatment. This suggests a higher risk of endothelial dysfunction in KTx patients on everolimus (EVR).

Area of Science:

  • Pediatric Nephrology
  • Transplantation Immunology
  • Vascular Biology

Background:

  • The impact of immunosuppressive regimens on vascular health in pediatric kidney transplant recipients (KTx) remains unclear.
  • Assessing micro- and macro-vascular status is crucial for long-term outcomes in KTx patients.

Purpose of the Study:

  • To investigate the association between everolimus (EVR)-based immunosuppression and vascular status in pediatric KTx recipients.
  • To compare micro- and macro-vascular function in KTx patients on EVR versus standard immunosuppression.

Main Methods:

  • A cross-sectional, case-control study involving 44 pediatric KTx patients.
  • Vascular markers included carotid intima-media thickness (cIMT), pulse wave velocity (PWV), and skin microvascular blood flow (laser-Doppler-fluximetry).
  • Serum levels of angiopoietins, FGF23, and soluble klotho were measured.

Main Results:

  • EVR-treated patients showed significantly reduced skin microvascular function compared to standard treatment (p<0.001).
  • Both groups exhibited similar hypertension and increased cIMT compared to healthy controls.
  • PWV and soluble klotho levels were comparable between the EVR and standard treatment groups.

Conclusions:

  • Everolimus-based immunosuppression is associated with impaired endothelial function in pediatric KTx patients.
  • Endothelial dysfunction appears more prevalent in KTx recipients receiving EVR compared to standard immunosuppressive therapy.
Abstract

Keywords:
AtherosclerosisChildrenEndothelial dysfunctionEverolimusKidney transplantationSkin microcirculation

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