Search

Introduction. Despite their potential benefits, mineralocorticoid receptor antagonists are rarely used in kidney transplant recipients due to the fear of complications. We aim to describe epidemiological, clinical and laboratory characteristics, treatment, and outcomes of kidney transplant patients treated with eplerenone. Methods. Kidney transplant recipients who received eplerenone were included in this single-center retrospective study. Serum electrolytes, uric acid, estimated glomerular filtration rate (eGFR), and proteinuria were recorded. Results. Ten kidney transplant recipients (6 male) received eplerenone for treatment of heart failure. With the median follow-up of 16 months (range 6-78 months), nine were alive with the functioning kidney allograft. Eplerenone was well tolerated. Only one patient developed mildly elevated potassium and one developed severe symptomatic hyponatremia, requiring hospitalization. The glomerular filtration rate decreased after eplerenone's introduction from 47.5(42-54) to 40 (35-48) ml/min/1.73m2 at three months (p<0.01) and remained stable in follow-up. Proteinuria decreased from 303 mg/24h to 185 mg/24h without a statistically significant difference. Eplerenone did not influence cyclosporine or tacrolimus trough levels. Uric acid increased after the introduction of eplerenone, requiring increased doses of allopurinol. Conclusions. Eplerenone may be used with caution in kidney transplant recipients. Careful monitoring of all electrolytes and not only of potassium is mandatory. In our cohort, eplerenone increased uric acid levels. Further studies are required to elucidate the clinical benefits and safety of eplerenone in this patient population. [ABSTRACT FROM AUTHOR]

We present a case of a 63-year-old female who developed toxic myopathy and liver damage after SARS-CoV-2 infection. To our best knowledge, this is the first case report about the combination of atorvastatin, remdesivir, ezetimibe, and tacrolimus related to myopathy and liver damage. Toxic myopathy and liver damage caused by concomitant therapy with remdesivir, atorvastatin, ezetimibe, and tacrolimus in a renal transplant patient with recently treated SARS-CoV-2 induced pneumonia: A case report. [Extracted from the article]

Background : Kidney transplantation is considered the best modality for renal replacement therapy. The use of immunosuppressive therapy and pre-existing and newly developed comorbidities predispose these patients to the use of a large number of medications. (Hyper)polypharmacy is associated with worse adherence and negative outcomes. This study aims to explore the factors correlated with hyperpolypharmacy and complex medication regimens in kidney transplant recipients. Methods : This is a cross-sectional study of outpatient kidney transplant recipients. Collected data include demographic data, complete chronic medication lists, medical history, and graft function. Linear and logistic regression were used to identify factors associated with hyperpolypharmacy and complex medication regimens. Medication regimen complexity was quantified by the Medication Regimen Complexity Index (MRCI). Results : Overall, 224 kidney transplant recipients were included, with an average time since transplantation of 8 years. Hyperpolypharmacy was present in more than two-thirds of patients; the average number of different medications was 12; and the mean MRCI score was 21.4, ranging from 6 to 50. Hypertension was almost universally present, while other frequently prescribed medication groups were hypolipemics, medication for bone-mineral metabolism disorders, gout, and antihyperglycemics. Conclusions : Factors independently associated with hyperpolypharmacy and complex medication regimens were found to be age and graft function. Studies investigating interventions aimed at reducing medication complexity and increasing adherence should focus on older patients with worse graft function.