The impact of long-term cyclosporin-A therapy on hematological and biochemical profile in renal transplant patients.
With over a decade of extensive clinical use of cyclosporin A (CsA), assessment of its long-term safety implications is due. In this study the impact of long-term continuous use of CsA on a number of hematological and biochemical parameters in renal transplant patients was evaluated. Two groups of 13 patients each, one on conventional therapy (azathioprine + prednisolone) and the other on triple therapy (azathioprine + prednisolone + CsA) for 4 to 15 years post-transplantation were compared with respect to their current and overall laboratory values and clinical outcome. Laboratory values were also compared with those of 23 matched healthy subjects. No significant difference in the clinical outcome was found between conventional and triple therapy groups, however, the triple therapy group had significantly less favorable mean values compared to the conventional therapy group with respect to hemoglobin (12.1 +/- 2.2 vs 13.3 +/- 2.1 g/dl, p < 0.02), hematocrit (0.36 +/- 0.06 vs 0.42 +/- 0.03 l/l, p < 0.05), urea (13.0 +/- 3.7 vs 6.7 +/- 4.3 mmol/l, p < 0.01) and uric acid (460.0 +/- 112 vs 330 +/- 88 mumol/l, p < 0.05). The increase in serum uric acid levels in the triple therapy group was progressive throughout the post-transplant period. For the 19 other parameters measured corresponding mean values in the 2 groups were comparable. Mean laboratory values for many parameters in both groups, however, still differed from those in the control group. These results showed that kidney transplant patients on long-term triple therapy have more hematological and biochemical abnormalities and no better clinical outcome than those on conventional therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Islam
S I
SI
Drug Monitoring Unit, King Fahd Medical Research Center, King Abdulaziz University, Saudi Arabia.
Ezeamuzie
C I
CI
Shaheen
F A
FA
Sheikh
I A
IA
Masuda
Q N
QN
Khaleel
M H
MH
D000328:Adult; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005454:Fluorescence Polarization; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome; D014508:Urea / Q000097:blood; D014527:Uric Acid / Q000097:blood
D015415:Biomarkers; D006454:Hemoglobins; D007166:Immunosuppressive Agents; D014527:Uric Acid; D016572:Cyclosporine; D014508:Urea; D011239:Prednisolone; D001379:Azathioprine