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5?mg/L. There were 17% of patients with proteinuria exceeding 800?mg/d. The most frequent reasons for conversion were ��CNI toxicity�� (28.7%), ��tumors�� (25.4%), ��creeping creatinine�� (22.7%), and ��chronic allograft nephropathy�� (18.7%). It is important to note http://www.selleckchem.com/products/MK-2206.html that multiple reasons could be ticked for individual patients. There were 80 patients (11.1%) who were included in various single and multicenter studies (e.g., skin cancer and creeping creatinine). The majority of patients converted due to tumors had skin tumors. Further analysis concerning tumors will be required. The immunosuppressive regimen before conversion to sirolimus consisted of corticosteroids (98.2%), CNIs such as cyclosporine or tacrolimus (90.2%), and antiproliferative immunosuppressants such as mycophenolic acid or azathioprine (86.5%). Prior antibody therapy was performed in 33.5% (13.8% depleting and 19.7% non-depleting antibodies). At conversion, the initial dose of sirolimus was 6.4?��?4.8?mg/d and the maintenance dose at the first visit post-conversion was 2.9?��?1.6?mg/d. The sirolimus trough level was 8.0?��?3.6?ng/mL and 8.2?��?1.2?ng/mL at six and 12?months, respectively. Three months after conversion, 70.3% were CNI free, 29.7% on low-dose CNI combination therapy (7.6% cyclosporine and 22.1% tacrolimus), 43.7% on antiproliferative medication (39.2% MPA and 4.5% azathioprine), and 87.7% on steroids. The vast majority of patients (72.9%) were treated with ACE inhibitors or ARB after conversion. In 65 patients (9.0%), BPAR was documented after conversion. Because of sequential inclusion and data collection during a period from 2000 to 2008, long-term follow-up was limited in some patients due to the available length of the remaining observation time. The average follow-up period was 2.3?��?1.8?yr, ranging from days up to the full recording period of nine?yr resulting in an overall observation time of 1561 patient years. The follow-up period exceeded three?yr in 33.4% of patients. The first objective of this study was to analyze the cohort with respect to changes in the baseline characteristics of the converted patients over the observation period. The age at transplantation and consequently also the age at conversion increased from the beginning of the study to the end of the observation period (Fig.?1A), with a mean of 44.2?��?12?yr in 2000 and 53.65?��?12.8?yr in 2008 (p?