Tacrolimus to Belatacept Conversion in Kidney Transplant Recipients
Author Information
Author(s): Efe Orhan, Al Jurdi Ayman, Eiting Morgan Mabey, Marks Christine Rogers, Cote Mariesa Ann, Wojciechowski David, Safa Kassem, Gilligan Hannah, Azzi Jamil, Goyal Nitender, Raynaud Marc, Loupy Alexandre, Weins Astrid, Riella Leonardo V.
Primary Institution: Massachusetts General Hospital
Hypothesis
Can converting from calcineurin inhibitors to belatacept improve outcomes in kidney transplant recipients with proteinuria?
Conclusion
Converting from calcineurin inhibitors to belatacept was associated with preserved kidney function and reduced proteinuria in kidney transplant recipients.
Supporting Evidence
- 53% of patients achieved at least a 25% reduction in proteinuria at 12 months.
- Median proteinuria decreased from 1.8 g/g to 1.4 g/g post-conversion.
- eGFR was maintained at 43 ml/min/1.73m2 at 12 months.
Takeaway
This study looked at whether changing medications could help kidney transplant patients with high protein levels in their urine. It found that the new medication helped keep their kidneys working well.
Methodology
This was a pilot phase II single-arm multicenter prospective trial involving adult kidney transplant recipients who were converted from calcineurin inhibitors to belatacept.
Potential Biases
The prescribing of ACEI or ARBs was at the discretion of the physician, which could have influenced outcomes.
Limitations
The study had a small sample size and lacked a randomized control group.
Participant Demographics
{"age":"61 (50 – 65)","male":"87%","ethnicity":{"Black":"20%","White":"47%","Asian":"13%","Hispanic":"20%"},"comorbidities":{"hypertension":"73%","diabetes":"40%"}}
Statistical Information
P-Value
0.068
Confidence Interval
{"proteinuria":"1.8 (IQR 1.4 – 3.5) g/g to 1.4 (IQR 0.4 – 2.2) g/g","eGFR":"48 (IQR 32 – 52.5) ml/min/1.73m2 to 43 (34 – 54.5) ml/min/1.73m2"}
Statistical Significance
p=0.068
Digital Object Identifier (DOI)
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