Comparison of Transplanted Kidney Function in Patients on Two Different Doses of Mycophenolate Mofetil

Mycophenolate mofetil (MMF), an immunosuppressant that is widely used in renal transplant recipients, is associated with several dose-dependent hematologic and gastrointestinal side effects that lead to drug dose reduction or even discontinuation. The aim of this study was to compare the renal funct...

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Bibliographic Details
Published in:	Transplantation proceedings 2006-09, Vol.38 (7), p.2035-2037
Main Authors:	Khosroshahi, H.T., Nahali, A., Gojazadeh, M., Shoja, M.M.
Format:	Article
Language:	eng
Subjects:	Adult Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Biological and medical sciences Dose-Response Relationship, Drug Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Fundamental immunology Glucocorticoids - therapeutic use Humans Immunosuppressive Agents - therapeutic use Kidney Transplantation - immunology Kidney Transplantation - physiology Male Medical sciences Middle Aged Mycophenolic Acid - analogs & derivatives Mycophenolic Acid - therapeutic use Pharmacology. Drug treatments Prednisolone - therapeutic use Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Tissue, organ and graft immunology
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Summary:	Mycophenolate mofetil (MMF), an immunosuppressant that is widely used in renal transplant recipients, is associated with several dose-dependent hematologic and gastrointestinal side effects that lead to drug dose reduction or even discontinuation. The aim of this study was to compare the renal function and acute rejection rates of kidney allograft recipients who were on two different mycophenolate mofetil doses. In a prospective study, 59 allograft kidney recipients who were on MMF 2 g/d were randomly selected and followed for evidences of acute rejection or drug side effects. Four patients were excluded from the study due to noncompliance, graft loss, and patient loss from opportunistic infection. Of the remaining 55 patients, 22 patients (40%) underwent MMF dose reduction to 1.35 ± 0.23 g/d due to perceived side effects or economic reasons (group 1). The mean time for this change was 4.2 ± 2.1 months after the kidney transplantation. The remaining patients (group 2, n = 33, 60%) had no change in MMF 2 g/d drug dosage. All patients were followed for at least 30 months after transplantation. Renal function tests (blood urea and serum cratinine) were measured monthly. Statistical analysis was performed using SPSS 11.0 (Student t test). A P value < .05 was considered significant. The two groups were comparable regarding age, gender, other immunosuppressive medications, and the time after transplantation. There were no episodes of acute rejection in group 1 after MMF dose reduction. The renal function (blood urea or serum creatinine levels) was comparable between the two groups at the end of study ( P = .846 and .610, respectively). MMF dose reduction was not associated with an increased risk of acute renal allograft rejection or impaired graft function.
ISSN:	0041-1345 1873-2623