Edema Associated With Everolimus de Novo

Area of Science:

• Nephrology
• Transplantation Immunology
• Pharmacology

Background:

• Edema is a limiting side effect of de novo everolimus, tacrolimus, and steroid immunosuppression in kidney transplantation.
• Investigating edema frequency and characteristics based on immunosuppression type is crucial for optimizing post-transplant care.

Purpose of the Study:

• To compare the incidence and characteristics of edema in kidney transplant recipients receiving de novo everolimus versus mycophenolic acid derivatives.
• To assess the impact of edema on patient and graft survival in different immunosuppression regimens.

Main Methods:

• A cohort study of 150 kidney transplant recipients from 2015-2017.
• Patients were divided into two groups: Group A (everolimus de novo) and Group B (mycophenolic acid derivatives).
• Data collected included edema occurrence, severity, treatment, and patient/graft survival.

Main Results:

• 54% of patients in the everolimus group (Group A) developed edema compared to 29% in the mycophenolic acid group (Group B) (P=.003).
• Edema was predominantly mild in both groups (74% in Group A, 57.1% in Group B).
• Despite higher incidence in Group A, edema did not significantly affect patient or graft survival, and improved in most patients.

Conclusions:

• De novo everolimus with tacrolimus and steroids causes edema in over half of kidney transplant recipients, but it is typically mild.
• Edema occurrence did not compromise renal function or survival outcomes when compared to mycophenolic acid derivatives.
• Management strategies, including diuretics and calcium channel blocker adjustments, were employed with favorable improvement rates.