Management of cyclosporine toxicity by reduced dosage and azathioprine.
While cyclosporine immunosuppression has improved the results of heart transplantation, nephrotoxicity and hypertension occurred in a large percentage of surviving patients. The potential irreversibility of these toxicities was noted in patients chronically exposed to cyclosporine. The immunosuppressive protocol was modified in those patients with a serum creatinine greater than 2.5 mg/100 mL. Azathioprine was added to the immunosuppressive regimen, and the dose of cyclosporine was steadily decreased until the creatinine was lowered. The combination of low-dose cyclosporine and azathioprine provided effective immunosuppression and was associated with a significant decrease in serum creatinine level, in systolic and diastolic blood pressures. Although it is premature to assess the long-term results of this immunosuppressive protocol, the early results are encouraging.
D001379:Azathioprine / Q000009:adverse effects / Q000627:therapeutic use*; D003524:Cyclosporins / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000187:drug effects; D016027:Heart Transplantation; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007674:Kidney Diseases / Q000139:chemically induced; D007970:Leukopenia / Q000139:chemically induced; D009181:Mycoses / Q000209:etiology
D003524:Cyclosporins; D001379:Azathioprine