Impact of cyclosporin immunosuppression on serum magnesium and its fractional excretion in renal transplant recipients.
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.
Nawaz
Syed Haider
SH
Sindh Institute of Urology and Transplantation, Dow Medical College and Civil Hospital, Karachi.
Zafar
Mirza Naqi
MN
Naqvi
Syed Ali Anwar
SA
Rizvi
Syed Adibul Hasan
SA
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
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D003404:Creatinine; D008274:Magnesium