Comparison of Cardiovascular Risk Profiles and Graft Function between Cyclosporin A-based and Tacrolimus-based Immunosuppression in Renal Transplant Recipients.
- Author:
Ji Young CHOI
1
;
Mi Kyung JIN
;
Joo Hyun CHUN
;
Seung Hyea HYUN
;
In Kyong HUR
;
Eun Young LEE
;
Ji Hyung CHO
;
Sun Hee PARK
;
Yong Lim KIM
;
Chan Duck KIM
Author Information
1. Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, Korea. drcdkim@knu.ac.kr
- Publication Type:Randomized Controlled Trial ; Original Article
- Keywords:
Cyclosporine;
Tacrolimus;
Cardiovascular system;
Graft survival
- MeSH:
Antihypertensive Agents;
Blood Pressure;
Cardiovascular System;
Cyclosporine*;
Diabetes Mellitus;
Fibrinogen;
Glucose;
Graft Survival;
Homocysteine;
Immunosuppression*;
Incidence;
Mortality;
Prospective Studies;
Risk Factors;
Tacrolimus;
Transforming Growth Factor beta;
Transplantation*;
Transplants*;
Uric Acid
- From:Korean Journal of Nephrology
2007;26(5):610-618
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Tacrolimus (TAC) may be less unfavorable than cyclosporin A (CsA) on cardiovascular morbidity and mortality in renal transplant recipients, but well controlled studies are insufficient. METHODS: In this prospective randomized controlled study, fifty seven consecutive renal transplant recipients were treated with CsA-based (CsA, MMF and steroid, CsA group: n=27) or TAC-based (TAC, MMF and steroid, TAC group: n=30) immunosuppressive regimens by randomized ratio of 1:1. In the baseline (pre-operation), 1, 3, and 6 months after transplantation, several cardiovascular risk factors and graft function were evaluated. RESULTS: There were no significant differences in the renal function, glucose regulation, the incidence of acute rejection and post-transplant diabetes mellitus for the post-transplant 6 months between the two groups. The blood pressure of the CsA group was maintained higher than TAC group through 6 months after transplantation even though the number of antihypertensive drugs in the CsA group was significantly higher at 3 and 6 month after transplantation. The lipid profiles except oxidized LDL were similar, but oxidized LDL level was significantly higher for the post-transplant 6 months in the CsA group (p<0.05). There were no significant differences in levels of fibrinogen, PAI-I, t-PA, hs-CRP, homocysteine, spot urine TGF-beta a and beta ig-h3, but the uric acid level was significantly higher in the CsA group (p<0.05). CONCLUSION: This study demonstrates that TAC tends to have a beneficial effect on cardiovascular risk profiles, with regard to BP and atherogenic properties of serum lipids in early post-transplant period.
