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首页> 外文期刊>Drug Design, Development and Therapy >Risk factors for calcineurin inhibitor nephrotoxicity after renal transplantation: a systematic review and meta-analysis
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Risk factors for calcineurin inhibitor nephrotoxicity after renal transplantation: a systematic review and meta-analysis

机译：肾移植后钙调磷酸酶抑制剂肾毒性的危险因素：系统评价和荟萃分析

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Background: Nephrotoxicity of calcineurin inhibitors (CNIs) is the major concern for long-term allograft survival despite its predominant role in current immunosuppressive regime after renal transplantation. CNI nephrotoxicity is multifactorial with demographic, environmental, and pharmacogenetic flexibility, whereas studies indicating risk factors for CNI nephrotoxicity obtained incomplete or conflicting results. Methods: A systematic review and meta-analysis of risk factors for CNI nephrotoxicity was performed on all retrieved studies through a comprehensive research of network database. Data were analyzed by Review Manager 5.2 with heterogeneity assessed using the Cochrane Q and I 2 tests. CNI nephrotoxicity was primarily indicated with protocol biopsy or index-based clinical diagnosis, and the secondary outcome was defined as delayed graft function. Results: Twelve observational studies containing a total of 2,849 cases were identified. Donor age (odds ratio [OR], 1.01; 95% CI, 1.01–1.03; p =0.02), recipient zero-time arteriosclerosis (OR, 1.44; 95% CI, 1.04–1.99; p =0.03), and CYP3A5*3/*3 genotype (OR, 2.80; 95% CI, 2.63–2.98; p =0.00) were confirmed as risk factors for CNI nephrotoxicity. Subgroup and sensitivity analysis claimed donor age as a significant contributor in Asian and Caucasian areas. Conclusion: Older donor age, recipient zero-time arteriosclerosis, and CYP3A5*3/*3 genotype might add up the risk for CNI nephrotoxicity, which could be interpreted into a robust biomarker system.
机译：背景：钙调神经磷酸酶抑制剂（CNIs）的肾毒性是同种异体移植长期存活的主要问题，尽管它在肾移植后目前的免疫抑制方案中起主要作用。 CNI肾毒性是多因素的，具有人口统计学，环境和药理遗传学的灵活性，而研究表明CNI肾毒性的危险因素获得的结果不完整或相互矛盾。方法：通过对网络数据库的全面研究，对所有检索到的研究进行了CNI肾毒性危险因素的系统评价和荟萃分析。数据由Review Manager 5.2分析，并使用Cochrane Q和I 2 测试评估异质性。 CNI肾毒性主要通过协议活检或基于指数的临床诊断来表明，其次要结果定义为移植物功能延迟。结果：确定了十二项观察性研究，共计2849例。供体年龄（比值[OR]，1.01; 95％CI，1.01-1.03; p = 0.02），接受者零时动脉硬化（OR，1.44; 95％CI，1.04-1.99; p = 0.03），以及CYP3A5 * 3 / * 3基因型（OR，2.80; 95％CI，2.63-2.98; p = 0.00）被确认为CNI肾毒性的危险因素。亚组和敏感性分析声称捐助者年龄是亚洲和高加索地区的重要贡献者。结论：供者年龄较大，受体零时态动脉硬化和CYP3A5 * 3 / * 3基因型可能加重CNI肾毒性的风险，这可以解释为健壮的生物标记系统。

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