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Outcomes of Mammalian Target of Rapamycin Inhibitor Regimens in Kidney Transplant Recipients with Pre- Transplant Primary Diagnosis of Hypertension and Other Etiologies: An Observational Study

Alfonso H Santos

We aimed to look at the outcomes related to the mammalian target of rapamycin inhibitor (sirolimus or everolimus), (m-TORi) regimens in kidney transplant recipients (KTR) with primary diagnoses of hypertension: In this retrospective observational study, 187,381 adult KTRs were classified into the hypertension or non-hypertension cohort supported their primary renal diagnosis pre-transplant. Cox regressions were used to analyze the risks for death and graft loss associated with the following regimens: m-TORi with or without steroids combined with cyclosporine (m-TORi+CSA), mycophenolate (m-TORi+MPA) or tacrolimus (m-TORi+Tac); cyclosporine with or without steroids combined with mycophenolate (CSA+MPA); and other regimens.Results: the danger of death-with-graft-function didn't differ between mTORi regimens in KTRs with a primary diagnosis of HTN [mTORi+CSA vs: mTORi+MPA (HR=0.88; 95% CI=0.68-1.14) and mTORi+Tac (HR=1.16; 95% CI=0.91-1.47); and mTORi+MPA vs. mTORi+Tac (HR=1.31; 95% CI=1.00-1.72)]. However, in KTRs with a primary diagnosis other than HTN, mTORi+CSA is associated with a lower risk of death-with-graft-function than mTORi+MPA or mTORi+Tac [mTORi+CSA vs. mTORi+MPA: HR=0.81; 95% CI=0.71-0.92] and [mTORi+CSA vs. mTORi+Tac: HR=0.76; 95% CI=0.66-0.87].