Format:
Online-Ressource
ISSN:
1423-0143
Content:
Introduction: Metrics for posttransplant immune monitoring to prevent over or under immunosuppression in renal transplant recipients (RTRs) are lacking. Methods: We surveyed 132 RTRs, 38 in the first year posttransplant and 94 〉1-year posttransplant, to study the clinical expression of immunosuppressive therapy. A questionnaire administered to these RTRs was divided into physical (Q physical) and mental (Q mental) symptoms. Results: In multivariable models for the association between the calculated Q physical and Q mental scores and different clinical and biochemical variables in the 38 RTRs who filled out the questionnaire 130 times during the first year posttransplant, it was found that mycophenolic acid (MPA) and prednisone use increased the mean Q physical score by 0.59 (95% CI: 0.21–0.98, p = 0.002) and 0.53 (95% CI: 0.26–0.81, p = 0.00), respectively, while MPA use increased the mean Q mental score by 0.72 (95% CI: 0.31–1.12, p = 0.001). Among the 94 RTRs who each completed the questionnaire only once, the odds for the mean Q mental score to be above the median value were more than 3 times higher for RTRs treated versus non-treated with MPA (OR 3.38, 95% CI: 1.1–10.3, p = 0.03). MPA-treated RTRs had higher mean scores for questions related to sleep disorders (1.83 ± 1.06 vs. 1.32 ± 0.67 for not treated, p = 0.037), to difficulty falling asleep (1.72 ± 1.11 vs. 1.16 ± 0.5, p = 0.02), and to depression and anxiety. Conclusion: We concluded that prednisone and MPA use are associated with an increased Q physical and Q mental scores in RTRs. Routine monitoring of physical and mental status of RTRs should be implemented to improve the diagnosis of overimmunosuppression. Dose reduction or discontinuation of MPA should be considered in RTRs who report sleep disorders, depression, and anxiety.
In:
volume:48
In:
number:1
In:
year:2023
In:
pages:445-459
In:
extent:15
In:
Kidney & blood pressure research, Basel [u.a.] : Karger, 1996-, 48, Heft 1 (2023), 445-459 (gesamt 15), 1423-0143
Language:
English
URN:
urn:nbn:de:101:1-2024010400051227721892
URL:
https://doi.org/10.1159/000530855
URL:
https://nbn-resolving.org/urn:nbn:de:101:1-2024010400051227721892
URL:
https://d-nb.info/1315003341/34
URL:
https://karger.com/kbr/article-pdf/48/1/445/4113944/000530855.pdf
URL:
https://karger.com/doi/10.1159/000530855
Bookmarklink