Conversion from cyclosporine to tacrolimus results in improved creatinine but does not alter lipid profile.
BACKGROUND
While cyclosporine and tacrolimus use results in similar renal graft survival, the side effect profiles of the drugs are substantially different. We examined the electrolyte and lipid alterations that occurred in our patient population following conversion from cyclosporine to tacrolimus.


METHODS
Data for electrolytes, lipid profile, and immunosuppression were analyzed from 98 patients with kidney or kidney-pancreas transplants who were converted from cyclosporine to tacrolimus between October 1994 and June 2001. Results, expressed as mean +/- SEM, were compared to baseline values using the Wilcoxon signed-rank test (P < .05 considered significant).


RESULTS
Among these patients, there were 56 men, 42 women, 75 primary transplants, 15 repeat transplants, and 26 multiorgan transplants. The mean time to tacrolimus conversion was 769 +/- 122 days. Creatinine, BUN, and glucose improved after conversion to tacrolimus. Surprisingly, cholesterol, low-density lipoproteins, and high-density lipoproteins levels were not significantly altered, although triglyceride levels demonstrated a significant difference at 1 year.


CONCLUSIONS
Significant improvements in creatinine and BUN were observed following conversion from cyclosporine to tacrolimus. While hypomagnesemia was also seen, there was surprisingly little alteration in lipid profile.
Woodside
K J
KJ
Department of Surgery, Division of Transplantation, University of Texas Medical Branch, Galveston, Texas 77555-0534, USA. woodside@umich.edu
Nichols
S D
SD
Hunter
G C
GC
Gugliuzza
K K
KK
Daller
J A
JA
D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D001806:Blood Urea Nitrogen; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood*; D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006085:Graft Survival / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000502:physiology*; D008055:Lipids / Q000097:blood*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D016035:Pancreas Transplantation / Q000502:physiology*; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007166:Immunosuppressive Agents; D008055:Lipids; D008074:Lipoproteins; D014280:Triglycerides; D016572:Cyclosporine; D002784:Cholesterol; D003404:Creatinine; D016559:Tacrolimus