MP59-19 ANTI-ATHEROSCLEROTIC EFFECT OF EVEROLIMUS IN KIDNEY-TRANSPLANTED PATIENTS

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery III (MP59)1 Apr 2020MP59-19 ANTI-ATHEROSCLEROTIC EFFECT OF EVEROLIMUS IN KIDNEY-TRANSPLANTED PATIENTS Takeshi Ishimura*, Takahito Endo, Shun Nishioka, Naoki Yokoyama, Teruyuki Oda, Satoshi Ogawa, and Masato Fujisawa Takeshi Ishimura*Takeshi Ishimura* More articles by this author , Takahito EndoTakahito Endo More articles by this author , Shun NishiokaShun Nishioka More articles by this author , Naoki YokoyamaNaoki Yokoyama More articles by this author , Teruyuki OdaTeruyuki Oda More articles by this author , Satoshi OgawaSatoshi Ogawa More articles by this author , and Masato FujisawaMasato Fujisawa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000928.019AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cardiovascular disease (CVD) is the major cause of death after kidney transplantation (KTx). Everolimus (EVR) is an immunosuppressive agent now widely used in KTx that is also known for its anti-atherosclerotic effect. The Ankle–Brachial Index (ABI), Carotid Artery Intima–Media Thickness (IMT), and Cardioankle Vascular Index (CAVI) provide indicators of atherosclerosis and are utilized as surrogate CVD markers in many diseases such as chronic kidney disease and diabetes. In this study, we explored the potential anti-atherosclerotic effect of EVR in KTx by sequentially assessing the ABI, IMT, and CAVI. METHODS: This study included 107 patients who recently underwent KTx with triple immunosuppression therapy consisting of calcineurin inhibitor (CNI, either tacrolimus or cyclosporine), mycophenolate mofetil, and methylprednisolone. Three months after KTx, EVR was added in 52 patients (EVR+ group), and 55 patients remained on conventional CNI-based immunosuppression therapy without EVR (EVR- group). The ABI, IMT (mm), and CAVI were examined 3 months and 1 year after KTx, and the mean of the right and left values of each test were regarded as an index of atherosclerosis. The changes in the values of each test from 3 months to 1 year were compared between the EVR+ and EVR- groups. Additionally, we determined the prognostic significance of EVR use in the progression of atherosclerosis as well as other clinical parameters. RESULTS: Overall, the mean ABI, IMT, and CAVI 3 months and 1 year after KTx were 1.125 ± 0.087 (n=107) and 1.137 ± 0.091 (n=100), 0.650 ± 0.199 (n=107) and 0.633 ± 0.310 (n=92), and 7.579 ± 1.348 (n=70) and 7.493± 1.623 (n=63), respectively; no significant differences from 3 months to 1 year were observed in each test. The changes in the ABI, IMT, and CAVI in the EVR+ vs. EVR- groups were 0.044 ± 0.093 vs. -0.011 ± 0.087 (p=0.003), -0.022 ± 0.127 vs. 0.033 ± 0.361, and 0.023 ± 1.487 vs. -0.173 ± 1.322, respectively. The ABI in the EVR- group showed a significant reduction from 3 months to 1 year than that in the EVR+ group. Furthermore, EVR non-use, high total cholesterol 3 months after KTx, and cyclosporine use were revealed as prognostic factors for a reduction in the ABI; however, the only independent prognostic factor determined on multivariate analysis was high total cholesterol 3 months after KTx. CONCLUSIONS: The results suggest that the early addition of EVR may prevent atherosclerosis progression after KTx. Further studies in more patients with a longer observation period may provide evidence of the anti-atherosclerotic effect of EVR. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e888-e888 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Takeshi Ishimura* More articles by this author Takahito Endo More articles by this author Shun Nishioka More articles by this author Naoki Yokoyama More articles by this author Teruyuki Oda More articles by this author Satoshi Ogawa More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement PDF downloadLoading ...