Effect of cyclosporin weaning on glomerular filtration rate in renal transplantation.
The objective of this study was to determine the effect of weaning cyclosporin on glomerular filtration rate in 55 renal transplant patients from the Renal Transplant Unit at the Royal Victoria Hospital. Men or women, older than 20 years of age, who received cadaveric or living-related renal transplant and who were treated with the complete cyclosporin protocol, were included. Weaning of cyclosporin was started 15 days after the prednisone dose was reduced to 15 mg/day and this weaning process was completed at day 105 posttransplant. The daily cyclosporin dose was decreased by 25 mg once every 2 weeks, and completely withdrawn after treatment when 50 mg/day was tolerated for 2 weeks. The duration of the weaning process varied because of fixed dose reduction. Renal graft function was assessed by plasma creatinine concentrations. We used the time point of cyclosporin discontinuation as time zero. Serum creatinine decreased over the time from 150 +/- 61 mmol/l at time zero to 100 +/- 18 mmol/l in the last determination, while GFR had a significant increment from 66 +/- 18 to 77 +/- 20. A total of 4 rejection episodes were observed 6 months after cyclosporin discontinuation. There were no graft failures and deaths. To determine predictors of improvement, we carried out multiple regression analysis and we found that prophylactic antilymphocyte globulin and the onset of graft function after transplantation were predictors.
Department of Nephrology, McGill University, Montreal, Que., Canada.
M
M
Salas
R
R
Loertscher
J J
JJ
Caro
D000328:Adult; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001794:Blood Pressure; D016572:Cyclosporine / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D013997:Time Factors; D014019:Tissue Donors
D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone; D008775:Methylprednisolone