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Faculty of Medical Sciences

‘Omschakeling van ciclosporine naar tacrolimus in niertransplantatiepatiënten; een vloek of zege?’

Engels, L.W. (2013) ‘Omschakeling van ciclosporine naar tacrolimus in niertransplantatiepatiënten; een vloek of zege?’. thesis, Medicine.

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Abstract

Introduction: In the past year improvements have been made in renal transplantation. Because of the introduction of calcineurin inhibitors the incidence of acute rejection has dramatically lowered and graft survival rates increased. As a result more attention is being put on the chronic complications like NODAT. The reported incidence varies between 2% and 50% percent. The presence of NODAT both negatively affects patient and graft survival. Goal: Some immunosuppressive agents have diabetogenic effects like corticosteroids and tacrolimus. In 2011 there has been a conversion from cyclosporine to tacrolimus. The reason for this is that tacrolimus is supposed to have fewer side effects and lowers the incidence of ARE. However it the incidence of ARE seemed to remain constant. Moreover the number of patients diagnosed with NODAT seemed to have increased. This research makes a comparison between cyclosporine and the incidence of both NODAT and ARE. Material and methods: A database was used consisting out of 257 renal transplantation patients. The total follow up was one year and five moments of follow up were present. WHO 2003 criteria were used to diagnose NODAT. Results: The total incidence of NODAT in the study population was 32.5%. Almost 80% was diagnosed before the first month after transplantation. The tacrolimus group had a significantly higher incidence. Tacrolimus turned out to be an independent predictor for NODAT even when adjusted for different covariates. In a Chi-square test tacrolimus use was more graft protecting than cyclosporine. However when further analysis was done, the significance was no longer present.

Item Type: Thesis (Thesis)
Supervisor name: Sanders, J.S.F.
Faculty: Medical Sciences
Date Deposited: 25 Jun 2020 10:50
Last Modified: 25 Jun 2020 10:50
URI: https://umcg.studenttheses.ub.rug.nl/id/eprint/1152

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