Serial decrease in glomerular filtration rate in long-term pediatric liver transplantation survivors treated with cyclosporine.
Serial calculations of glomerular filtration rate were made in 31 pediatric liver transplant recipients surviving more than 1 year. GFR was computed from the Schwartz formula, (cGFR = KL/S Cr), before orthotopic liver transplantation, and at 3-6 monthly intervals thereafter. At the same time points, CsA dose/kg, CsA level, blood pressure, and liver functions were recorded. The mean difference between the pre-OLT cGFR and the most-current cGFR for all patients was -50 ml/min/1.73 m2 (P = less than 0.005). In 17/31 (55%), the current cGFR was less than 80 ml/min/1.73 m2, indicative of renal impairment. The cGFR continued to decrease in 24 patients followed beyond 1 year (26.8 ml/min/1.73 m2 per year decrease, P less than 0.005). More patients with a cGFR less than 80 ml/min/1.73 m2 had outpatient hypertension. There was no correlation of cGFR with CsA levels, CsA dose, or liver function. We conclude that a significant decrease in cGFR is seen in children treated with CsA for more than 1 year, which is progressive in the majority.
McDiarmid
S V
SV
Department of Pediatric Gastroenterology, UCLA School of Medicine, Los Angeles, CA 90024.
Ettenger
R B
RB
Fine
R N
RN
Busuttil
R W
RW
Ament
M E
ME
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003524:Cyclosporins / Q000008:administration & dosage / Q000009:adverse effects* / Q000097:blood; D004334:Drug Administration Schedule; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D016031:Liver Transplantation; D008136:Longevity / Q000187:drug effects; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies
D003524:Cyclosporins