[Effects of diltiazem on arterial pressure and renal function in renal transplanted and cyclosporin A treated subjects. Results after 3 months of a prospective study].
With the aim to improve renal graft function and to prevent hypertension, we used the calcium-antagonist diltiazem in a prospective randomized study in 30 consecutive cadaveric renal transplanted patients from september 1987 to may 1988. The diltiazem (D+) group comprised 14 patients receiving a loading dose of 0.3 mg/kg followed by a 2 micrograms/kg/d continuous IV infusion of D started as soon as possible after clamp on renal artery removal. D was then given orally (120-180 mg/d) throughout the study. 16 patients without D composed the D- group. Cyclosporine A (csa) was started either just before transplantation (15 mg/kg/d orally) in 18 patients (9 D+ and 9 D-) or after 2-3 weeks of poly or monoclonal antibodies (5 D+ and 7 D- at 10 mg/kg/d. In addition to the usual monitoring, inulin (for GFR) and PAH (for ERBF), clearances were performed 7 days and 3 months after transplantation. If hypertension (blood pressure greater than 160/90 mm Hg) occurred, all but calcium-antagonists antihypertensive agents were used in both groups. Between D+ and D-, the number of patients requiring haemodialysis during the first week was not different (7/14 vs 5/16) like the number of dialysis session per patient (1.4 vs 1.1) day 7 GFR (19 +/- 22 vs 23 +/- 20) and day 7 ERBF (146 +/- 147 vs 226 +/- 224) ml/mn/1.73 m2; at 3 months 13/14 (93 p. 100) vs 12/15 (80 p. 100) of the grafts are functioning (NS), GFR (34 +/- 17 vs 33 +/- 10) and ERBF (242 +/- 90 vs 236 +/- 117) are not different.(ABSTRACT TRUNCATED AT 250 WORDS)
Guerin
C
C
Service de néphrologie, hôpital Nord, CHU de Saint-Etienne, Saint-Priest en Jarez, France.
Berthoux
P
P
Broyet
C
C
Berthoux
F
F
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects*; D003524:Cyclosporins / Q000627:therapeutic use; D004110:Diltiazem / Q000494:pharmacology*; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000502:physiology; D016030:Kidney Transplantation; D008875:Middle Aged; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors
D003524:Cyclosporins; D004110:Diltiazem
Effets du diltiazem sur la pression artérielle et la fonction rénale du transplanté rénal sous ciclosporine A. Résultats à trois mois d'une étude prospective.