[Hypertension induced by cyclosporin A in insulin-dependent diabetic patients. A one-year follow-up].
Forty-five recent insulin-dependent diabetics (IDD) were treated with cyclosporine A (CsA) 7.5 mg/kg b.i.d. as single immunosuppressive therapy to achieve remission of diabetes. Measurements of mean arterial pressure (MAP), glomerular filtration rate (GFR:inulin clearance), renal vascular resistance (RVR: MAP x [1-haematocrit] divided by PAH clearance), absolute (UNa.V) and fractional (FENa) urinary sodium excretion, were performed initially (M0) and after 3 (M3) and 12 (M12) months of treatment. Results were (mean +/- SD): [table: see text] Prevalence of hypertension defined as MAP greater than or equal to 107 mmHg was 12% at M3 and 24% at M12. Whereas the maximal changes in GFR and RVR occurred at M3, MAP increased further and sodium excretion decreased at M12.


CONCLUSIONS
1) CyA-induced increase in blood pressure paralleled that in RVR at M3 and decreased sodium excretion at M12. 2) There was a dissociation between MAP and GFR changes after 12 months of treatment with CyA.
Hannedouche
T
T
Département de néphrologie, hôpital Necker, Paris.
Natov
S
S
Garev
L
L
Marques
L P
LP
Boitard
C
C
Lacour
B
B
Assan
R
R
Bach
J F
JF
Grünfeld
J P
JP
D000328:Adult; D001794:Blood Pressure; D003524:Cyclosporins / Q000009:adverse effects* / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000503:physiopathology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000503:physiopathology; D009318:Natriuresis; D011446:Prospective Studies; D014655:Vascular Resistance
D003524:Cyclosporins
Hypertension induite par la ciclosporine A chez les sujets diabétiques insulinodépendants. Suivi à un an.