Conversion from Tacrolimus to cyclosporine A in renal transplantation recipients with NODAT
10.3760/cma.j.issn.1674-6090.2012.06.004
- VernacularTitle:肾移植后新发糖尿病患者的免疫抑制方案转换
- Author:
Xiaoting XU
;
Chibing HUANG
;
Mingqi FAN
- Publication Type:Journal Article
- Keywords:
Diabetes mellitus;
Kidney transplantation;
Calcineurin inhibitor(CNI);
Insulin
- From:
Journal of Endocrine Surgery
2012;6(6):375-378
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the efficiency and safety of conversion from tacrolimus(Tac)to cyclosporine A(CsA) in patients with new onset diabetes after transplantation (NODAT).Methods The glucose metabolism parameters and related clinical indicators in 45 Tac treated renal transplantation recipients who developed NODAT were retrospectively analyzed.The oral immunosuppressive strategy was Tac + mycophenolate mofetil (MMF) + prednisone(Pred).Results 32 cases were converted to CsA whereas 13 patients stuck to Tac.After conversion,fasting plasma glucose (FPG)decreased from(8.2 ± 2.7)mmol/L to(5.9 ± 1.2)mmol/L(P ＜ 0.01)and HbA1c level decreased from (7.0 ± 0.9) ％ to (6.1 ± 0.7) ％ (P ＜ 0.05).The level of FPG and HbA1c was lower in the conversion group than in the control group(P ＜ 0.05).During the 1-year follow-up,the curative rate of NODAT was 53.1％ (17/32) in the conversion group while it was 0％ in the control group.No acute rejection happened after the conversion.There was no obvious change in renal function.The 1-year survival rate of patient and the transplanted kidney was 100％.Blood pressure and lipid levels were stable after the conversion.Conclusion Conversion from Tac to CsA is a simple and effective strategy to improve glucose metabolism in renal transplantation recipients with NODAT.
