Comparison of the effects of standard vs low-dose prolonged-release tacrolimus with or without ACEi/ARB on the histology and function of renal allografts.

Targeting the renin-angiotensin system and optimizing tacrolimus exposure are both postulated to improve outcomes in renal transplant recipients (RTRs) by preventing interstitial fibrosis/tubular atrophy (IF/TA). In this multicenter, prospective, open-label controlled trial, adult de novo RTRs were randomized in a 2 × 2 design to low- vs standard-dose (LOW vs STD) prolonged-release tacrolimus and to angiotensin-converting enzyme inhibitors/angiotensin II receptor 1 blockers (ACEi/ARBs) vs other antihypertensive therapy (OAHT). There were 2 coprimary endpoints: the prevalence of IF/TA at month 6 and at month 24.

Generic immunosuppression in solid organ transplantation: a Canadian perspective.

The introduction of generic immunosuppressant medications may present an opportunity for cost savings in solid organ transplantation if equivalent clinical outcomes to the branded counterparts can be achieved. An interprofessional working group of the Canadian Society of Transplantation was established to develop recommendations on the use of generic immunosuppression in solid organ transplant recipients (SOTR) based on a review of the available data. Under current Health Canada licensing requirements, a demonstration of bioequivalence with the branded formulation in healthy volunteers allows for bridging of clinical data.

Similar outcomes for Canadian renal transplant recipients followed up in transplant centers and satellite clinics.

Background: A significant proportion of long-term care for renal transplant recipients (RTRs) in Canada is provided by community nephrologists in satellite clinics (SCs). The outcomes of RTRs followed up in SCs have not been formally compared with those followed up in transplant centers (TCs).

Methods: This multicenter retrospective study from 13 TCs and SCs across Canada compared patient and graft outcomes in RTRs with a functioning graft more than or equal to 18 months.

Development of end stage renal disease following an acute cardiac event.

We determined the rate and risk factors for end-stage renal disease (ESRD) in consecutive patients discharged after a cardiac event in a large, unbiased Canadian cohort that receives universal health coverage. A total of 8236 adults hospitalized over a 2 year period were followed for up to 7.5 years and the incidence of ESRD and mortality determined.

Outcomes of acute coronary syndrome in a large Canadian cohort: impact of chronic renal insufficiency, cardiac interventions, and anemia.

Background: Chronic renal insufficiency (CRI) has been identified as an important risk factor for cardiac events. Studies in the United States reported decreased survival and decreased use of surgical and medical interventions after myocardial infarction in patients with CRI.

Methods: We studied the impact of renal function on health outcomes in a Canadian cohort of consecutive patients admitted with acute coronary syndrome (ACS) between October 1997 and October 1999.