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Risk factors for reaching renal endpoints in the assessment of Lescol in renal transplantation (ALERT) trial
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (The Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators)
(the Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators)
(the Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators)
(the Assessment of LEscol in Renal Transplantation (ALERT) Study Investigators)
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2005 (English)In: Transplantation, ISSN 0041-1337, E-ISSN 1534-6080, Vol. 79, no 2, 205-212 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The aim of the study was to identity risk factors for long-term renal transplant function and development of chronic allograft nephropathy (CAN) in renal transplant recipients included in the Assessment of Lescol in Renal Transplantation (ALERT) trial. METHODS: The ALERT trial was a randomized, double-blind, placebo-controlled study of the effect of fluvastatin, 40 and 80 mg/day, in renal transplant recipients who were randomized to receive fluvastatin (Lescol) (n = 1,050) or placebo (n = 1,052) over 5 to 6 years of follow-up. Renal endpoints including graft loss or doubling of serum creatinine or death were analyzed by univariate and multivariate regression analysis in the placebo group. RESULTS: There were 137 graft losses (13.5%) in the placebo group, mainly caused by CAN (82%). Univariate risk factors for graft loss or doubling of serum creatinine were as follows: serum creatinine, proteinuria, hypertension, pulse pressure, time since transplantation, donor age, human leukocyte antigen-DR mismatches, treatment for rejection, low high-density lipoprotein cholesterol, and smoking. Multivariate analysis revealed independent risk factors for graft loss as follows: serum creatinine (relative risk [RR], 3.12 per 100-microM increase), proteinuria (RR, 1.64 per 1-g/24 hr increase), and pulse pressure (RR, 1.12 per 10 mm Hg), whereas age was a protective factor. With patient death in the composite endpoint, diabetes mellitus, smoking, age, and number of transplantations were also risk factors. CONCLUSIONS: Independent risk factors for graft loss or doubling of serum creatinine or patient death are mainly related to renal transplant function, proteinuria, and blood pressure, which emphasizes the importance of renoprotective treatment regimens in this population.

Place, publisher, year, edition, pages
2005. Vol. 79, no 2, 205-212 p.
National Category
Urology and Nephrology
Research subject
Medicine
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URN: urn:nbn:se:uu:diva-104221PubMedID: 15665769OAI: oai:DiVA.org:uu-104221DiVA: diva2:219555
Available from: 2009-05-27 Created: 2009-05-27 Last updated: 2017-12-13Bibliographically approved

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