Edema Associated With Everolimus de Novo |
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| Institution: | 1. Heart Failure and Transplantation Unit, Cardiology Department, University and Polytechnic La Fe Hospital, Valencia, Spain;2. Myocardial Dysfunction and Cardiac Transplantation Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain;3. Consorcio Centro de Investigación Biomédica en Red, M.P (CIBERCV), Madrid, Spain;1. Heart Failure and Transplant Unit, La Fe University and Polytechnic Hospital, Valencia, Spain;2. Department of Cardiology, La Fe University and Polytechnic Hospital, Valencia, Spain;3. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain;4. University of Valencia, Valencia, Spain;1. Heart Failure and Transplant Unit, La Fe University and Polytechnic Hospital, Valencia, Spain;2. Department of Cardiology, La Fe University and Polytechnic Hospital, Valencia, Spain;3. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain;4. Clinical Analysis Department, La Fe University and Polytechnic Hospital, Valencia, Spain;5. Pathological Anatomy Department, La Fe University and Polytechnic Hospital, Valencia, Spain;6. Universidad de Valencia, Valencia, Spain |
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| Abstract: | BackgroundThe appearance of edema limits the use of everolimus de novo together with tacrolimus and steroids in kidney transplantation. We aimed to investigate the frequency and characteristics of patients with edema and compare them according to the type of immunosuppression.MethodsWe studied 150 kidney transplant recipients between 2015 and 2017 based on receiving everolimus de novo (group A) or mycophenolic acid derivatives (group B).ResultsWe analyzed 50 patients in group A and 100 in group B. Follow-up was 26.2 ± 10 months. Fifty-six patients presented edema (37.3%): 54% in group A and 29% in group B (P = .003). Edema was mild in 74% of patients in group A and 57.1% in group B. The probability of edema was 10.1%, 22.4%, and 41% at 3, 6, and 12 months, respectively, in group A vs 10.1%, 20.3%, and 25.4% in group B (P = .006). Patients were treated mostly with diuretics (14.3% in group A vs 27.6% in group B) and discontinuation of calcium channel blockers (46.4% in group A vs 48.3% in group B). Improvement was 70.4% in group A vs 60.7% in group B; patient worsening was 0% in group A vs 10.7% in group B; and there was no change in 29.6% in group A vs 28.6% in group B. We did not find differences in patient or graft survival in those who presented edema, regardless of the treatment group.ConclusionThe use of everolimus and standard doses of tacrolimus caused edema in 54% of patients, with no impact on renal function or survival compared with mycophenolic acid derivatives. The edema was mostly of low intensity and improved in most patients. |
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