engleski

Everolimus may promote bone resorption and glucose intolerance in renal transplant recipients

There is an increasing body of clinical experience demonstrating the proliferation inhibitor of the macrolide class, everolimus has the potential to improve outcomes after renal transplantation mostly due to improvement of renal function. However, the impact on bone turnover or intermediary metabolism has not been established so far. We analysed baseline demographic data and laboratory findings regarding bone turnover markers, fasting plasma glucose (FPG) levels, lipid profile and kidney function of 81 kidney transplant recipients (51, 62.96% males) median age 57.50 (23-75) years with 3 (0-21) years spent on hemodyalisis receiving either everolimus (n=35, 43.2%), sirolimus (n=13, 16.05%), tacrolimus (n=15, 18.52%) or cyclosporine (n=18, 22.23%). The ANOVA between group comparrisson has shown differences in telopeptid (p=0, 001) and FPG (p<0, 001) levels. Post hoc Scheffe test has shown that the group of patients receiving everolimus had higher levels of telopeptide than the group receiving tacrolimus (0.990(0.447-3.129) ng/mL vs 0.609(0.130-1.420) ng/mL , p=0.036) or cyclosporine (0.990(0.447-3.129) ng/mL vs 0.547(0.230-1.120) ng/mL, p=0, 006) and higher levels of FPG compared to group receiving sirolimus (6.30 (4.30-8.40) mmol/L vs 5.00(4.30- 6.10) mmol/L, p<0.001), tacrolimus (6.30 (4.30- 8.40) mmol/L vs 5.00(4.20-8.60) mmol/L, p=0.004) and cyclosporine (6.30 (4.30-8.40) mmol/L vs 4.6(3.90-5.70) mmol/L, p<0.001). Our reasults suggest that everolimus could have an impact on bone turnover by promoting bone resorption and that it could promote glucose intollerance as well. In order to acess long-term endpoint data further study evaluation will be required.

everolimus; bone resorption; glucose intollerance

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