Clinical features and treatment of calcineurin inhibitor-induced pain syndrome in renal transplant recipients
10.12206/j.issn.1006-0111.202101014
- VernacularTitle:肾移植受者中钙调神经磷酸酶抑制剂致疼痛综合征的临床特征及治疗
- Author:
Ling TONG
1
;
Xing FAN
2
;
Airong YU
1
Author Information
1. Department of Clinical Pharmacy,.
2. Department of Nephrology, General Hospital of Central Theater Command of PLA, Wuhan 430070, China.
- Keywords:
renal transplantation;
calcineurin inhibitors;
pain syndrome;
clinical features;
treatment
- From:
Journal of Pharmaceutical Practice
2022;40(1):84-88
- CountryChina
- Language:Chinese
-
Abstract:
Objective To understand the clinical features and therapeutic methods for calcineurin inhibitor-induced pain syndrome (CIPS) in kidney transplant recipients. Methods The related articles or abstracts from January 1991 to December 2020 were obtained by searching PubMed, Google Scholar, CNKI, Wanfang and VIP databases. The reviews, duplicate literatures and the articles involved in non-kidney transplant recipients were excluded. 11 full papers were included with 15 case reports. Results The average age of patients at the time of diagnosis of CIPS was (44.6±8.31) years, and the 53.3% of the patients was male. The average appearance time of CIPS was (2.42±3.07) months after kidney transplantation. CIPS mainly affected bilateral hands, elbows, wrists, knees, ankles, feet and back. The patients had normal or elevated trough concentrations of calcineurin inhibitors (CNIs) when CIPS occurred. Some patients had elevated alkaline phosphatase, parathyroid hormone, blood calcium, C-reactive protein levels, and abnormal phosphorus levels, while rheumatoid factor and uric acid levels were normal. CIPS symptoms in most patients disappeared with dose reduction of CNIs, change to different class of CNIs, pamidronate IV injection, pregabalin, calcium channel antagonists, etc. The average recovery time was (4.43±3.31) months. Conclusion The most effective treatment for CIPS is to reduce the dose of CNIs and replace immunosuppressants. Other treatments include GABA analogs, intravenous pamidronate, calcium channel blockers and conservative therapy.
