Everolimus Based Calcineurin Inhibitors Minimization Regimens in Renal Transplantation Recipients: A Meta-Analysis.

Abstract

Background Calcineurin inhibitors (CNIs) are widely-used immunosuppressants in renal transplantation, although it has been proved that CNIs can cause nephrotoxicity. Minimization of CNIs seems a better immunosuppression protocol after renal transplantation. Here we conduct a meta-analysis on the outcomes of CNI minimization by Everolimus in renal transplant recipients. Methods We included randomized trials with no year and language restriction. All data were analyzed using fix or random effect model. The primary endpoints were estimated glomerular filtration rate (eGFR), biopsy proven acute rejection (BPAR) and patient survival at month 12. The secondary endpoints were incidence of infection, blood creatinine level, allograft dysfunction, and other side effects such as hypertriglyceridemia. ResultseGFR was significantly improved in Everolimus group (MD=5.41, 95% CI 0.63 to 10.19, Z=2.22, P=0.03). There was no significant difference in BPAR episodes (RR=1.29, 95% CI=0.82 to 2.04, Z=1.10, P=0.27), patient survival (RR=0.88, 95% CI=0.45 to 1.75, Z=0.35, P=0.73), overall infection rate (RR=0.99, 95%CI=0.93 to 1.06, Z=0.28, P=0.78) and incidence of hypertriglyceridemia (RR=0.94, 95%CI=0.56 to 1.57, Z=0.24, P=0.81).Table: No Caption available.Conclusion The findings of this meta-analysis suggest that CNI minimization regimen with Everolimus elicits benefits in renal function, while not comprising immunosuppressive effects.