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Immunsuppressive Medikamente in der Therapie nach Nierentransplantation

Immunosuppressants in the treatment of kidney transplant recipients

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Zusammenfassung

Mit den Calcineurininhibitoren Ciclosporin A und Tacrolimus, den DNA-Synthesehemmern Mycophenolsäure und Azathioprin und nicht zuletzt den TOR-Inhibitoren Everolimus und Sirolimus stehen derzeit eine Vielzahl von Medikamenten für die Immunsuppression nach Nierentransplantation zu Verfügung. Diese werden noch durch Antikörper und Steroide ergänzt. In dem vorliegenden Artikel werden neben den grundlegenden Daten zur Pharmakokinetik, dem Nebenwirkungsprofil und dem Interaktionspotenzial der Immunsuppressiva die Möglichkeiten und Grenzen verschiedener derzeit eingesetzter Medikamentenkombinationen einschließlich aktueller Richtlinien der Rejektionstherapie diskutiert.

Abstract

Currently two calcineurin inhibitors (cyclosporin A, tacrolimus), three DNA synthesis inhibitors (mycophenolate, mycophenolatmofetil, azathioprin) and two TOR inhibitors (everolimus, sirolimus) are used for immunosuppressant therapy in kidney transplant recipients. Steroids and different types of antibodies may extend immunosuppressant regimens. The present article discusses pharmacokinetic data, adverse effects and interaction profiles of these drugs and the possibilities opened up by various combinations in current use and their limitations; it also deals with current guidelines on treating rejection.

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Interessenkonflikt

Der Autor erhielt projektbezogene Unterstützung durch Novartis, Stella, Wyeth, Roche. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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  1. Klinik für Nieren- und Hochdruckerkrankungen , Universitätsklinikum Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 12, 24105, Kiel, Deutschland

    L. Renders & U. Kunzendorf

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  1. L. Renders
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  2. U. Kunzendorf
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Correspondence to L. Renders.

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Renders, L., Kunzendorf, U. Immunsuppressive Medikamente in der Therapie nach Nierentransplantation. Nephrologe 2, 157–166 (2007). https://doi.org/10.1007/s11560-007-0080-4

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  • DOI: https://doi.org/10.1007/s11560-007-0080-4

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