title: Elevated plasminogen activator inhibitor levels in cyclosporin-treated renal allograft recipients.
abstract: Atherosclerosis and thrombosis, two major causes of morbidity and mortality in renal transplant recipients, share the same clinical risk factors including decreased fibrinolysis and lipid disturbances. In a cross-sectional study we have determined parameters of fibrinolysis in control subjects (n = 23) and stable renal allograft recipients without cyclosporin (CsA) (n = 10) and with CsA (n = 87) in their immunosuppressive treatment. In CsA-treated patients, tissue-type plasminogen activator was moderately increased compared to patients without CsA (8.4+/-3.3 vs 5.5+/-2.8 ng/ml). The plasminogen activator inhibitor (PAI) activity in plasma was clearly increased in CsA-treated patients: 14.5+/-8.8 vs 7.2+/-3.2 in normal controls and 8.5+/-2.4 AU/ml in patients without CsA. Total cholesterol and LDL cholesterol levels were higher in CsA-treated patients (256+/-62 and 169+/-60 mg/dl) than in patients without CsA (209+/-45 and 136+/-44 mg/dl). The two groups did not differ in HDL cholesterol, triglycerides, and lipoprotein(a). Hypercholesterolaemia, obesity, and steroid-induced diabetes could be identified as risk factors for elevated plasma PAI activity in CsA-treated patients. Hypofibrinolysis induced by elevated PAI levels and increased LDL cholesterol may contribute to the increased thrombogenicity and accelerated atherosclerosis observed in cyclosporin-treated patients.
authors.affiliation: Department of Nephrology, University Hospital Antwerpen, Edegem-Antwerpen, Belgium.
authors.forename: G A
authors.initials: GA
authors.lastname: Verpooten
authors.forename: F J
authors.initials: FJ
authors.lastname: Cools
authors.forename: M G
authors.initials: MG
authors.lastname: Van der Planken
authors.forename: L C
authors.initials: LC
authors.lastname: Bedert
authors.forename: R
authors.initials: R
authors.lastname: Claes
authors.forename: L F
authors.initials: LF
authors.lastname: Van Gaal
authors.forename: M E
authors.initials: ME
authors.lastname: De Broe
mesh_terms: D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D005342:Fibrinolysis; D006084:Graft Rejection / Q000097:blood / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015849:Plasminogen Inactivators / Q000032:analysis*; D012307:Risk Factors; D014184:Transplantation, Homologous
chemical_list: D007166:Immunosuppressive Agents; D015849:Plasminogen Inactivators; D016572:Cyclosporine