The comparison of the effects of inhibitors and si̇rolimus in renal transplatation patients

Renal transplantation is accepted as the best treatment option for the patients who has end stage kidney disease without any life thereatening morbidity. The immunsuppressive medications that are used to prevent rejection after transplantation must be well controlled for the greft and patient recipients survival. Primary immunsupressive therapy protocols usually target T cells and consists of corticosteroids, mycophenolate mofetil/ mycophenolic acid combined with calcineurin inhibitors like tacrolimus/cyclosporine and a m-TOR inhibitor; sirolimus. In this study we searched the effects of calcineurin inhibitors and sirolimus on allograft function and the patient metabolic status. This study included 189 renal transplant recipients who regularly followed in Nephrology Department of Baskent University Ankara Hospital. Patients divided into two groups (group 1: patients under sirolimus treatment, group 2: patient under calcineurin inhibitor treatment) and followed for two years. The adverse events, complications, comorbidities, differanties in laboratory parameters, clinical symptoms, changes through graft and patient survival caused by the treatment regimen from calcineurin inhibitors to sirolimus are compared. Furthermore, the patients in these two groups are divided into subgroups according to the transplantation duration. In conclusion we find out that there was no differences on mortality rate, acute rejection episodes, enfections and hospitalisations between two groups (p> 0,05). Dyslipidemia and proteinuria were seen mostly in patients who was under sirolimus treatment (p< 0,05). In the first nine months of the posttrasplantation period,there was tend to be seen hyperglycemia (p: 0,03). Patients who switched to sirolimus in 12 months after transplantation had better renal function tests (p< 0,05). Key words: Calcineurin inhibitor, Sirolimus, Renal function