title: The effect of calcineurin inhibitors on endothelial function in renal transplant recipients.
abstract: Endothelial dysfunction is of vital importance, as it may cause ischemia and dysfunction in various organs. Despite, this problem has been well documented in patients with end-stage renal disease (ESRD), there is not enough data considering this issue following renal transplantation. One of the potential causes of endothelial dysfunction in renal transplant recipients may be administration of calcineurin inhibitors. The aim of this study is to evaluate the effects of two different calcineurin inhibitors [cyclosporin A (CsA) and tacrolimus (FK506)] on endothelial function in renal transplant patients. Forty-four renal transplant recipients [22 on FK506 (group I) and 22 on CsA (group II)] were studied. Endothelial functions of the brachial artery were evaluated by using high resolution vascular ultrasound. Endothelium-dependent and -independent vasodilations were assessed by establishing reactive hyperemia and using sublingual nitroglycerine (NTG), respectively. Results are presented as percentage change from baseline values. Significant endothelial dysfunction was noted in renal transplant patients treated with CsA. While endothelium-dependent vasodilation was 12.1 +/- 5.1% in group I and it was 6.5 +/- 3.7% in group II (p < 0.001). The increase in brachial artery diameter after sublingual NTG was 20.1 +/- 6.3 and 12.7 +/- 5.6% in groups I and II, respectively. This indicates that the endothelium-dependent and -independent vasodilation of the patients on FK506 is better preserved than the patients on CsA therapy. Besides, blood flow volume (BFV) increase was 51.2 +/- 39.4 and 43.9 +/- 24.3%, in groups I and II, respectively, in reactive hyperemia period (p > 0.05). Post-transplant course of renal transplant recipients is complicated by endothelial dysfunction. This problem is more prominent in patients on CsA therapy, which can predispose these patients to more frequent cardiac complications.
authors.affiliation: Department of Cardiology, Istanbul School of Medicine, Istanbul, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Oflaz
authors.forename: Aydin
authors.initials: A
authors.lastname: Turkmen
authors.forename: Rumeyza
authors.initials: R
authors.lastname: Kazancioglu
authors.forename: Seyit M
authors.initials: SM
authors.lastname: Kayacan
authors.forename: Banu
authors.initials: B
authors.lastname: Bunyak
authors.forename: Hakan
authors.initials: H
authors.lastname: Genchallac
authors.forename: Bulent
authors.initials: B
authors.lastname: Erol
authors.forename: Fehmi
authors.initials: F
authors.lastname: Mercanoglu
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Umman
authors.forename: Mehmet S
authors.initials: MS
authors.lastname: Sever
mesh_terms: D000328:Adult; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000627:therapeutic use*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000502:physiology*; D008297:Male; D016559:Tacrolimus / Q000627:therapeutic use*; D014463:Ultrasonography; D014664:Vasodilation / Q000187:drug effects
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus