Evidence mapPaperPMID 42367253Full record

ArticleFrontiers in transplantation2026

An exploration of markers of microvascular dysfunction in kidney transplant recipients randomized to belatacept: no clinical impact of CNIs on endothelial function.

Edwin O W Bredewold, Rudmer J Postma, Joe Chan, My H S Svensson, Annette Bruchfeld, Johannes W de Fijter, Hans Furuland, Anders Hartmann, Lars Mjornstedt, Karin Skov and 7 more

Abstract read
In one paragraph

Article in Frontiers in transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Edwin O W BredewoldDepartment of Transplantation and Nephrology, Leiden University Medical Center (LUMC), Leiden, Netherlands.
Rudmer J PostmaDepartment of Transplantation and Nephrology, Leiden University Medical Center (LUMC), Leiden, Netherlands.
Joe ChanDepartment of Nephrology, Akerhus University Hospital, Lorenskog, Norway.
My H S SvenssonInstitute of Clinical Medicine, Akerhus University Hospital, Lorenskog, Norway.
Annette BruchfeldDepartment of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden.
Johannes W de FijterDepartment of Transplantation and Nephrology, Leiden University Medical Center (LUMC), Leiden, Netherlands.
Hans FurulandDepartment of Medical Sciences, Uppsala Universitet, Uppsala, Sweden.
Anders HartmannDepartment of Transplantation Medicine, University of Oslo, Oslo, Norway.
Lars MjornstedtDepartment of Surgery, Goteborg University, Goteborg, Sweden.
Karin SkovDepartment of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.
Inga SoveriDepartment of Medical Sciences, Uppsala Universitet, Uppsala, Sweden.
Soeren S SorensenDepartment of Clinical Medicine, Rigshospitalet, Copenhagen University, Copenhagen, Denmark.
Bengt FellstromDepartment of Medical Sciences, Uppsala Universitet, Uppsala, Sweden.
Jacques M DuijsDepartment of Transplantation and Nephrology, Leiden University Medical Center (LUMC), Leiden, Netherlands.
Roel BijkerkDepartment of Transplantation and Nephrology, Leiden University Medical Center (LUMC), Leiden, Netherlands.
Joris I RotmansDepartment of Transplantation and Nephrology, Leiden University Medical Center (LUMC), Leiden, Netherlands.
Anton-Jan van ZonneveldDepartment of Transplantation and Nephrology, Leiden University Medical Center (LUMC), Leiden, Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Side effects of calcineurin inhibitors (CNI) comprise hypertension, diabetes and nephrotoxicity, and endothelial dysfunction (ED) has often been implicated. Belatacept, a co-stimulation blocker, may offer a more favourable vascular profile. Methods: We investigated markers of endothelial function in blood samples from kidney transplant recipients (KTR) that were converted from CNI to belatacept. We assessed established markers of ED including soluble thrombomodulin, P-selectin and angiopoietin 1 and 2. In addition, we assessed expression levels of microRNAs (miRNAs), which have been identified as discriminative markers for ED, rejection and renal fibrosis in the setting of transplantation. Lastly, we used patient samples and CNI-dilution series in a validated model of ED in which changes in morphological characteristics of endothelial cells were evaluated. Results: Unexpectedly, we found no differences in our assays between both groups. We did observe dose-related effects of CNI on endothelial cell (EC) morphology upon direct exposure of EC to tacrolimus and ciclosporin A, but a similar effect was not seen when plasma samples of KTR who were converted to belatacept were compared with samples from KTR on CNI's. Discussion: These data suggest that CNI-side-effects bundled under the term "CNI-toxicity" are not derived from a significant clinical effect of CNI on endothelial function.

Indexed as

belatacept conversioncalcineurin inhibihibitor nephropathyendothel dysfunctionkidney tranplantationrandomiced clinical trial

Identifiers

PMID42367253
PMCPMC13294043

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.