2003
DOI: 10.1056/nejmoa020009
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The Natural History of Chronic Allograft Nephropathy

Abstract: Chronic allograft nephropathy represents cumulative and incremental damage to nephrons from time-dependent immunologic and nonimmunologic causes.

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Cited by 1,778 publications
(1,557 citation statements)
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References 21 publications
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“…Until the BANFF 2005 meeting, chronic changes in transplanted kidneys had been summarized as chronic allograft nephropathy [49], with interstitial fibrosis and tubular atrophy as the surrogate markers in biopsies [50]. However, it took some time before this diagnosis was integrated into routine care.…”
Section: Chronic Antibody-mediated Rejection (Camr)mentioning
confidence: 99%
“…Until the BANFF 2005 meeting, chronic changes in transplanted kidneys had been summarized as chronic allograft nephropathy [49], with interstitial fibrosis and tubular atrophy as the surrogate markers in biopsies [50]. However, it took some time before this diagnosis was integrated into routine care.…”
Section: Chronic Antibody-mediated Rejection (Camr)mentioning
confidence: 99%
“…Calcineurin inhibitors (CNIs) have been linked to declining renal function and chronic allograft nephropathy, which may eventually lead to allograft failure 20. There is a need for effective non–CNI‐based immunosuppressive regimens; however, data on non–CNI‐based regimens in recipients of ECD kidneys are limited.…”
Section: Introductionmentioning
confidence: 99%
“…Exploratory analyses that compared the 100 participants who remained compliant with sirolimus with the 186 participants who remained compliant with tacrolimus yielded an apparent difference in transplant function among those participants allocated and adherent to sirolimus (difference in mean values 2.9 mL/min/1.73 m2, SE 1.4 mL/min/1.73 m2; adjusted P  = .05; Table S6A). The 18‐month mean eGFR of participants who discontinued allocated treatment was 8.9 (4.2) mL/min/1.73 m2 lower among those assigned sirolimus compared with those assigned tacrolimus, whereas it was 2.9 (1.4) mL/min/1.73 m2 higher among those who did not discontinue allocated treatment.…”
Section: Resultsmentioning
confidence: 99%
“…However, despite improvements in short‐term transplant survival, long‐term rates have not improved in recent decades 1. Calcineurin inhibitors (CNIs, eg, tacrolimus) are central to modern immunosuppression but are associated with graft fibrosis and atrophy, worsening transplant function, and long‐term transplant failure 2, 3. Immunosuppression strategies that minimize CNI exposure may be expected, therefore, to reduce the rate of late transplant failure 4…”
Section: Introductionmentioning
confidence: 99%