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Afterward, sirolimus was discontinued http://www.selleck.cn/products/AP24534.html in further 17/51 (33%) patients and cyclosporine in further 15/62 (24%) patients. As a result, the proportion of patients still receiving at 5 years the study drug as randomized initially was higher in the CsA group than in the SRL group (Table 2), but the difference was not statistically significant (p = 0.091). Reasons for discontinuing cyclosporine or sirolimus are displayed in Table 3. In the two groups, the primary reason was the occurrence of adverse events. The majority of adverse events occurred in the CsA group between 1 and 2 years, while the adverse events in the SRL group occurred evenly during the follow-up. Almost all patients in the two groups were treated with MMF whereas about one-fourth of patients received corticosteroids at 5 years posttransplant (Table 2). The daily dose at 5 years posttransplant http://www.selleckchem.com/products/Rapamycin.html of the study drug allocated initially is provided in Table 2. In the SRL group, mean study drug trough levels were 8.7 �� 2.8 ng/mL and the mean daily dose was 2.7 �� 1.1 mg. In the CsA group, mean study drug trough levels were 94.7 �� 23.6 ng/mL and the mean daily dose was 2.7 �� 1.1 mg. Renal function estimated either by the MDRD eGFR, the Nankivell eGFR or the Cockcroft-Gault CrCl is provided in Table 4 in patients from the ITT population having a functional graft (n = 114) and in the OT population. In the ITT population, renal function was superior in the SRL group than in the CsA group. Mean MDRD eGFR at 1 year, 2, 3 and 5 years is displayed in Figure 2. Interestingly, mean MDRD eGFR, which was similar in both groups at 1 year, became significantly superior in the SRL group than in the CsA group at 2 and 3 years (p http://www.selleckchem.com/products/jq1.html mL/min/month was calculated in the CsA group, whereas a positive eGFR slope of 0.04 mL/min/month was calculated in the SRL group. The calculated difference between the two slopes is 0.109 mL/min/month (p = 0.019). Similar results were observed when renal function was estimated according to Nankivell or Cockcroft and Gault. When analyzing those patients actually maintained for 5 years on the study drug allocated initially (OT population), mean Nankivell eGFR, MDRD eGFR and Cockcroft-Gault CrCl were higher in patients treated with sirolimus compared to those treated with cyclosporine (Table 4). Consistently, this difference between groups was previously observed in the OT 1-year population (10). To note, the difference between groups of MDRD eGFR value progressively increased from 7.4 mL/min at 1 year to 17.5 mL/min at 5 years posttransplant.