title: Impact of cyclosporin immunosuppression on serum magnesium and its fractional excretion in renal transplant recipients.
abstract: OBJECTIVE
  To evaluate the effect of cyclosporine (CSA) on serum magnesium and its fractional excretion in renal transplant recipients.
  
  
  METHODS
  A cross sectional comparative study on 50 live related renal transplant recipients on CSA therapy with serum creatinine < 2.0 mg/dl and 30 healthy controls. Serum creatinine, magnesium and its fractional excretion and CSA levels were monitored. Patients were followed at 6 months.
  
  
  RESULTS
  The mean serum creatinine in patients was 1.41 +/- 0.42 mg/dl, cyclosporine 210 +/- 66 ng/ml at a dose of 4.8 +/- 1.4 mg/kg/day. The serum magnesium was 1.77 +/- 0.32 mg/dl vs 1.98 +/- 0.17 mg/dl in healthy controls (p < 0.05). Fractional excretion was 5.05 +/- 2.53% in patients vs 2.8 +/- 1.05% in controls (p < 0.05). No correlation was found between CSA levels (100-400 ng/ml) and serum magnesium (r = 0.053) or FEMg% (r = 0.215). Of the 50 recipients 27 (54%) had FEMg% in the control range. At 6 months follow up no difference in CSA levels was found between recipients with FEMg% in the normal range vs those with FEMg > 5%. However, serum creatinine increased from 1.42 +/- 0.30 mg/dl to 1.68 +/- 0.82 mg/dl (p < 0.05).
  
  
  CONCLUSIONS
  CSA therapy lowers serum magnesium as compared to healthy controls and there is marked increase in FEMg% in 50% of the patients. Patients with FEMg > 5% developed renal function deterioration. FEMg percent can thus be a good follow up marker of CSA chronic toxicity in stable transplant recipients.
authors.affiliation: Sindh Institute of Urology and Transplantation, Dow Medical College and Civil Hospital, Karachi.
authors.forename: Syed Haider
authors.initials: SH
authors.lastname: Nawaz
authors.forename: Mirza Naqi
authors.initials: MN
authors.lastname: Zafar
authors.forename: Syed Ali Anwar
authors.initials: SA
authors.lastname: Naqvi
authors.forename: Syed Adibul Hasan
authors.initials: SA
authors.lastname: Rizvi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood / Q000652:urine; D003430:Cross-Sectional Studies; D016572:Cyclosporine / Q000009:adverse effects / Q000378:metabolism* / Q000627:therapeutic use*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000378:metabolism* / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000276:immunology*; D008274:Magnesium / Q000097:blood* / Q000652:urine; D008297:Male; D012079:Renal Circulation / Q000187:drug effects; D014661:Vasoconstriction
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine; D008274:Magnesium