A double-blind, randomized, placebo-controlled study of nifedipine on early renal allograft function.
A double-blind, randomized, placebo-controlled study was conducted to determine the effect of nifedipine on early renal allograft function when added to a triple therapy immunosuppression regime comprising low-dose cyclosporin (CsA), prednisolone and azathioprine. Fifty adult cadaveric renal allograft recipients were randomized to placebo (group P n = 17), nifedipine 10 mg preoperatively and 20 mg b.d. postoperatively for 48 h, followed by matching placebo for 3 months (group NS n = 16) or nifedipine 10 mg preoperatively and 20 mg b.d. postoperatively for 3 months (group NL n = 17). Donor and recipient exclusion criteria included recent calcium antagonist treatment. At 3 months after transplantation mean GFR adjusted for graft loss was significantly higher in group NL than in NS (mean +/- SD 61 +/- 28 versus 34 +/- 25 ml/min/1.73 m2; P < 0.05), group P being intermediate (45 +/- 34 ml/min/1.73 m2). Similarly, effective renal blood flow (ERBF) at 3 months was higher in group NL than in groups P and NS (mean +/- SD 351 +/- 175 versus 216 +/- 166 and 220 +/- 162 ml/min/1.73 m2; P < 0.05). The differences were not significant by 6 months post-transplantation. This study suggests that oral nifedipine commenced preoperatively and continued for 3 months following transplantation has beneficial effects on early renal allograft function when incorporated as part of an immunotherapy regimen based on cyclosporin.
Royal London Hospital, Whitechapel, UK.
M E
ME
Wilkie
J C
JC
Beer
S J
SJ
Evans
M J
MJ
Raftery
R H
RH
Lord
R
R
Moore
F P
FP
Marsh
D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005921:Glomerulonephritis / Q000209:etiology; D006084:Graft Rejection; D006085:Graft Survival / Q000187:drug effects*; D006801:Humans; D007668:Kidney / Q000502:physiology*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000209:etiology; D013997:Time Factors
D016572:Cyclosporine; D009543:Nifedipine