Recurrence of oxalate deposition in a renal transplant during ciclosporin A therapy.
A 14.5-year-old boy with end-stage renal failure due to familial primary hyperoxaluria underwent cadaver donor renal transplantation. The graft function was stable for a period of 22 months, while he was on conventional immunosuppressive therapy (prednisolone and azathioprine) and additional oral pyridoxine, phosphorus, and magnesium supplementation. When ciclosporin A was introduced instead of azathioprine, the blood levels of oxalate rose, and oxalate deposition in the renal tubuli became evident. These observations suggest that ciclosporin A interferes with oxalate metabolism and, therefore, should be given with utmost caution in patients with primary hyperoxaluria.
Drachman
R
R
Division of Pediatric Nephrology, Shaare Zedek Medical Center, Jerusalem, Israel.
Dollberg
L
L
Drukker
A
A
D000293:Adolescent; D003524:Cyclosporins / Q000009:adverse effects*; D006801:Humans; D006959:Hyperoxaluria / Q000150:complications*; D006960:Hyperoxaluria, Primary / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D010070:Oxalates / Q000378:metabolism*; D012008:Recurrence
D003524:Cyclosporins; D010070:Oxalates