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1.
Iran J Kidney Dis ; 14(2): 145-152, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32165600

RESUMEN

INTRODUCTION: There are some randomized trials which have already evaluated different calcineurin inhibitors (CNIs), especially comparing Tacrolimus and Cyclosporine, as immunosuppressant agents in children. However, their findings have been occasionally conflicting and thus debatable. Therefore, the evidence on safety and efficacy of immunosuppressive therapy after kidney transplantation in children has been inconclusive and argued to date. This study was aimed to compare the benefits and disadvantages of tacrolimus versus cyclosporine as the primary immunosuppression after renal transplantation in children. METHODS: A systematic review and meta-analysis was done. An electronic literature review was conducted to identify appropriate studies. The outcomes were presented as relative risk, with 95% confidence intervals. RESULTS: Five qualified randomized controlled trials were included in this systematic review. Tacrolimus was insignificantly superior to cyclosporine considering the total effect size of graft loss (RR = 0.67, 95% CI: 0.40 - 1.11; P > .05) and acute rejection (RR = 0.79, 95% CI: 0.59 - 1.05; P > .05). On the contrary, cyclosporine seemed to be insignificantly superior to tacrolimus regarding mortality rate (RR = 1.06, 95% CI: 0.59 - 1.90; P > .05). CONCLUSION: Admitting the study limitations mainly because of the nature and case study size of the included trials, it can be concluded from our systematic review results that Tacrolimus seems insignificantly superior to Cyclosporine respecting graft loss and acute rejection. However, Cyclosporine was shown to be insignificantly superior regarding mortality rate. However additional studies with a larger sample size are highly recommended.


Asunto(s)
Ciclosporina/administración & dosificación , Rechazo de Injerto/prevención & control , Supervivencia de Injerto/efectos de los fármacos , Trasplante de Riñón/efectos adversos , Tacrolimus/administración & dosificación , Inhibidores de la Calcineurina/administración & dosificación , Inhibidores de la Calcineurina/efectos adversos , Niño , Ciclosporina/efectos adversos , Rechazo de Injerto/inmunología , Rechazo de Injerto/mortalidad , Humanos , Inmunosupresores/administración & dosificación , Inmunosupresores/efectos adversos , Trasplante de Riñón/mortalidad , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Tacrolimus/efectos adversos , Factores de Tiempo , Resultado del Tratamiento
2.
J Clin Exp Dent ; 10(5): e462-e468, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29849971

RESUMEN

BACKGROUND: Diagnosis of oral complications in the dialysis patients is important to prevent potential infections. The aim of this cross-sectional study was to compare oral findings in dialysis patients with healthy individuals and determination of the correlation of these findings and laboratory tests. MATERIAL AND METHODS: In this cross-sectional study, DMFT, dmft, DI , CI , OHIS , PI, GI and enamel defects were evaluated in 25 hemodialysis patients, 30 peritoneal dialysis patients and 26 healthy individuals. Then the correlation of laboratory tests (including Hemoglobin, Urea, Creatinine, Ca, Na, Ph, K and ALP) and oral findings was determined in each groups using SPSS (Version 16). Data analyzed with One-way ANOVA test, Chi-Square , Kruskal-Wallis , Tukey's test and Fisher's-Exact test. RESULTS: Findings revealed significant differences in dmft, DI, CI, OHIs, PI and GI between study groups. A positive correlation between Ca and DI was found in hemodialysis group. In peritoneal dialysis group positive significant correlations between DMFT index and Urea, Cr , ALP and K , between OHIs and K , between PI and Cr and negative correlations between Na and CI and OHIs were found. CONCLUSIONS: Presence of oral problems in dialysis patients, especially hemodialysis, indicate the necessity of appropriate therapeutic considerations in these patients. The correlation of blood biochemical compounds and oral status in dialysis patients may warn clinicians to control the level of the biochemical blood compounds for oral health improvement. Key words:Hemodialysis, laboratory tests, oral findings, peritoneal dialysis.

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