Introduction: The prevalence of cardiovascular disease in kidney transplant recipients (KTR) is four times higher than in general population. Pulse wave velocity is considered an independent predictor of cardiovascular mortality in patients with end stage renal disease. mTORi have demonstrated protector effect on endothelium through the decrease of arterial blood pressure and left ventricular mass. The objective of this study has been to assess the effect of the conversion from calcineurin inhibitor (CNI) to an everolimus (EVR) based regimen on endothelial function, arterial wall stiffness, 24 hours Ambulatory Blood Pressure Monitoring (ABPM), Left Ventricular Mass Index (LVMI) and Glomerular Filtration Rate (MDRD4). Methods: Open, prospective, one year study with a control arm (C) in stable KTR. Twenty KTR were converted to EVR (due to a medical need) and ten patients with similar baseline conditions were continued on the original CNI as C, patients aged 51±10 EVR and 43±13 for C, with 81±46 months of dialysis pretransplant for EVR and 83±52 for C, were enrolled at 3 to 12 months after transplant: 7±3 EVR and 5±1.5 C. Stiffness Index (Si), Reflection index (Ri) and its variations after salbutamol (ΔRib/Ris), diurnal and nocturnal (D and N) ABPM, LVMI and MDRD4 were assessed baseline (0) and at month 12 (12) post conversion. We report a descriptive analysis of the data. Results: At 12, 7 patients discontinued: 5 EVR and two C. Main results are reported in table 1. No effect has been observed in Si, Ri or ΔRib/Ris indexes, either in EVR or in C arm (results not shown). Statistical significant reductions were found in NABPM and LVMI. MDRD changes in both arms were not statistically significant, but oriented in opposite directions.

Conclusion: After 12 months of conversion to EVR from CNI no changes were registered in the experimental arm on Si, Ri and endothelial function ( ΔRib/Ris). Patients experienced a statistical significant reduction in NABPM and LVMI. A numerical increase in MDRD4 was observed.

Schiavelli, R.: Grant/Research Support, Everolimus. Kornhall, B.: Employee, Novartis. Otero, A.: Employee, Novartis. Dragon-Durey, M.: Grant/Research Support, Everolimus.

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