Cleveland Clinic Lerner College of Medicine, Glickman Urological and Kidney Institute, Cleveland, Ohio 44195, USA.
Kidney Int. 2011 Apr;79(8):804-6. doi: 10.1038/ki.2010.557.
The search continues for the best role for mTOR inhibitor drugs in renal transplantation-principally to avoid or minimize the nephrotoxicity of the CNI class of immunosuppressive agents. The Spare the Nephron Trial describes the popular approach of early conversion from a CNI to the mTOR agent sirolimus for patients maintained on mycophenolate mofetil and steroids. At 1-2 years the glomerular filtration rate (GFR) was superior for the sirolimus group, with a loss of tolerability for about 20%.
目前仍在探索雷帕霉素靶蛋白（mTOR）抑制剂在肾移植中的最佳应用，主要目的是避免或尽量减少钙调磷酸酶抑制剂（CNI）类免疫抑制剂的肾毒性。“保留肾单位试验”（Spare the Nephron Trial）描述了一种常用的方法，即对于接受霉酚酸酯和皮质类固醇治疗的患者，早期将 CNI 转换为 mTOR 药物西罗莫司。1-2 年后，西罗莫司组的肾小球滤过率（GFR）更高，但大约有 20%的患者出现不耐受。
