Abstract
The initial enthusiasm for the advent of a potentially nonnephrotoxic immunosuppressant has been muted by data unmasking nephrotoxicity of mammalian target of rapamycin inhibitors, including renal podocyte injury resulting in proteinuria. Adverse reactions, including anemia, thrombocytopenia, hyperlipidemia, and especially diabetogenesis, have limited its use to niche indications such as prevention or amelioration of malignancy in organ transplant. The class seems to be best used to address malignancy in organ allograft recipients and as a first-line therapy in lymphangioleiomyomatosis.
MeSH terms
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Anemia / epidemiology
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Enzyme Inhibitors / adverse effects*
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Enzyme Inhibitors / pharmacology
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Enzyme Inhibitors / therapeutic use*
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Humans
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Hyperlipidemias / epidemiology
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Immunosuppressive Agents / adverse effects
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Immunosuppressive Agents / pharmacology
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Immunosuppressive Agents / therapeutic use
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Organ Transplantation*
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Podocytes / drug effects
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Podocytes / pathology
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Proteinuria / epidemiology*
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Risk Factors
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TOR Serine-Threonine Kinases / antagonists & inhibitors*
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Thrombocytopenia / epidemiology
Substances
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Enzyme Inhibitors
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Immunosuppressive Agents
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TOR Serine-Threonine Kinases