Sirolimus has tubulotoxic effects at therapeutic trough levels of 10-20 ng/mL, according to research presented here at the meeting of the European Renal Association and European Dialysis and Transplant Association (ERA-EDTA).
The data showed sirolimus has tubulotoxic properties — resulting in a Fanconi-like syndrome — that was promptly reversible when therapy was discontinued, reported Dr. Stefan Franz from the department of Transplantation and Immunology and Nephrology, University Hospital, Basel, Switzerland, who presented the data here on July 15th.
When sirolimus was first introduced, there was great hope that it would achieve adequate immunosuppression without nephrotoxicity. Previous studies have reported hypophosphataemia, metabolic alkalosis and low uric acid as possible consequences of tubular damage, Dr. Franz said. Early animal studies gave the first hint that sirolimus might have nephrotoxic properties.
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