The beneficial effects of oral nifedipine on cyclosporin-treated renal transplant recipients--a randomised prospective study.
The aim of this study was to test the hypothesis that nifedipine will improve graft survival in cyclosporin A (CyA)-treated renal transplant recipients. One hundred and forty-seven patients were randomised to one of three regimens. Group A received CyA, 7 mg/kg per day, and prednisolone; group B followed the same regimen as group A plus oral nifedipine and group C received CyA, 4 mg/kg per day, prednisolone and azathioprine. Calcium channel blockers were avoided in groups A and C. The crude 2-year (P = 0.0223) and 4-year (P = 0.0181) graft survival was significantly better in group B (86% and 81%, respectively) than in group A (75% and 63%, respectively). Delayed initial function was seen least frequently in group B (10.2%) compared to groups A (31%) and C (28%; P < 0.01). Group B also experienced fewer rejection episodes than groups A and C (P < 0.05). We conclude that the combination of oral nifedipine and CyA significantly improves initial graft function, rejection frequency and long term graft survival.
Harper
S J
SJ
Department of Nephrology, Leicester General Hospital, UK.
Moorhouse
J
J
Abrams
K
K
Jurewicz
A
A
Nicholson
M
M
Horsburgh
T
T
Harris
K
K
Combe
C
C
Bell
P R
PR
Walls
J
J
Donnelly
P K
PK
Veitch
P S
PS
Feehally
J
J
D000284:Administration, Oral; D000328:Adult; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D003404:Creatinine / Q000378:metabolism; D016572:Cyclosporine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006084:Graft Rejection / Q000188:drug therapy* / Q000401:mortality; D006085:Graft Survival / Q000187:drug effects*; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D016030:Kidney Transplantation / Q000276:immunology*; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage*; D011446:Prospective Studies; D015996:Survival Rate
D002121:Calcium Channel Blockers; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine; D009543:Nifedipine