Findings

What do systematic reviews say?

1,097 questions · 1,119 findings · 70 reviews · Kidney and Transplant

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No studies found 271 · 24.2%GRADE not reported 17 · 1.5%Very low 271 · 24.2%Low 349 · 31.2%Moderate 182 · 16.3%High 29 · 2.6%

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: primary outcomes

Outcomes (up to 2 years for primary outcomes) · primary immunosuppression in kidney transplant recipients

The review found no eligible studies for this question.

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: primary outcomes

Death (all causes) · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) showed no clear difference in death (all causes) compared with antimetabolites: primary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.06 [0.84, 1.33]
31 studies · 10482 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: primary outcomes

Graft loss (censored) · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) showed no clear difference in graft loss (censored) compared with antimetabolites: primary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.09 [0.82, 1.45]
26 studies · 8966 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs calcineurin inhibitors (CNI): main outcomes

Death (all causes) · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) showed no clear difference in death (all causes) compared with calcineurin inhibitors (CNI): main outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.31 [0.87, 1.98]
19 studies · 3618 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: primary outcomes

Biopsy‐proven acute rejection · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) showed no clear difference in biopsy‐proven acute rejection compared with antimetabolites: primary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 0.95 [0.81, 1.12]
24 studies · 10101 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: primary outcomes

CMV infection · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) probably leads to lower CMV infection compared with antimetabolites: primary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 0.44 [0.34, 0.58]
26 studies · 10049 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: primary outcomes

Wound complications · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) probably leads to higher adverse wound outcomes: all complications compared with antimetabolites: primary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.56 [1.28, 1.9]
17 studies · 6913 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: primary outcomes

All malignancies · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) showed no clear difference in all malignancies compared with antimetabolites: primary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 0.83 [0.64, 1.07]
17 studies · 8799 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: primary outcomes

Number needing to change treatment · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) probably leads to higher number needing to change treatment compared with antimetabolites: primary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.56
25 studies · 9747 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

Outcomes (up to 2 years for secondary outcomes) · primary immunosuppression in kidney transplant recipients

The review found no eligible studies for this question.

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

New onset of diabetes · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) probably leads to higher new‐onset diabetes mellitus compared with antimetabolites: secondary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.28 [1.07, 1.54]
23 studies · 8728 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

BK virus infection · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) leads to lower BK virus infection compared with antimetabolites: secondary outcomes (high certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 0.62 [0.5, 0.76]
12 studies · 5152 participants
High

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

GFR · primary immunosuppression in kidney transplant recipients

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
no estimate extracted
25 studies · 7099 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

Hypercholesterolaemia · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) may leads to higher hypercholesterolaemia compared with antimetabolites: secondary outcomes (low certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.83 [1.48, 2.25]
12 studies · 5725 participants
Low

Target of rapamycin inhibitors (TOR‐I) vs calcineurin inhibitors (CNI): main outcomes

Graft loss censored for death · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) showed no clear difference in graft loss censored for death compared with calcineurin inhibitors (CNI): main outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.32 [0.96, 1.81]
14 studies · 3277 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

Hypertriglyceridaemia · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) probably leads to higher hypertriglyceridaemia compared with antimetabolites: secondary outcomes (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.48 [1.26, 1.74]
9 studies · 4698 participants
Moderate

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

Leucopenia · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) may leads to lower leucopenia compared with antimetabolites: secondary outcomes (low certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 0.43 [0.33, 0.56]
15 studies · 8396 participants
Low

Target of rapamycin inhibitors (TOR‐I) vs antimetabolites: secondary outcomes

Thrombocytopenia · primary immunosuppression in kidney transplant recipients

Target of rapamycin inhibitors (TOR‐I) may leads to higher thrombocytopenia compared with antimetabolites: secondary outcomes (low certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.96 [1.38, 2.79]
8 studies · 5028 participants
Low

Intervention not reported

Outcomes (up to 2 years for primary outcomes) · primary immunosuppression in kidney transplant recipients

The review found no eligible studies for this question.

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
no estimate extracted
Studies not reported
No studies found

Intervention not reported

Death (all causes) · primary immunosuppression in kidney transplant recipients

The intervention showed no clear difference in death (all causes) (moderate certainty).

1 finding from 1 review

Target of rapamycin inhibitors (TOR‐I; sirolimus and everolimus) for primary immunosuppression in kidney transplant… 2019 · Cochrane Headline outcomes only
RR 1.07 [0.64, 1.78]
9 studies · 1501 participants
Moderate