Renal calcium handling after rapamycin conversion in chronic allograft dysfunction.
To study the effect of rapamycin on calcium balance, we conducted a prospective study on transplant recipients. The patients were converted to rapamycin and observed for 6 months (C). Urinary Ca and P, ALK-p, Ca, P, and intact parathyroid hormone (iPTH) were examined before and 6 months after conversion. A nonconversion group (N) was found for comparison. Sixteen patients entered the study. There were increases of ALK-p (C: 67.4 +/- 32.9 to 79.6 +/- 37.0*; N: 67.3 +/- 25.1 to 67.8 +/- 14.7 IU) (*P < 0.05), Ca(2+) (C: 8.7 +/- 0.3 to 9.5 +/- 0.2*; N: 8.8 +/- 0.4 to 8.7 +/- 0.5 mg/dl), urinary P excretion (C: 287.6 +/- 257.1 to 439.4 +/- 260.9*; N: 233.9 +/- 117.2 to 264.8 +/- 143.4 mg/day) and iPTH (C: 133.7 +/- 149.6 to 200.6 +/- 171.5*; N: 128.4 +/- 57.1 to 136.3 +/- 40.4 pg/ml). Serum P (C: 5.3 +/- 1.4 to 3.6 +/- 0.6*; N: 5.2 +/- 0.8 to 5.1 +/- 0.9 mg/dl) and urinary Ca(2+) (C: 93.9 +/- 52.6 to 31.8 +/- 45.1*; N: 84.6 +/- 38.3 to 75.9 +/- 38.4 mg/day) were decrease. Rapamycin was associated with decreased urinary Ca(2+) and increased P excretion. The alteration might come from the increased parathyroid hormone.
Wu
Mai-Szu
MS
Department of Nephrology, School of Medicine, Chang-Gung University, Chang Gung Memorial Hospital, Keelung, Taiwan. maisuwu@yahoo.com
Hung
Cheng-Chieh
CC
Chang
Chiz-Tzung
CT
D000328:Adult; D002118:Calcium / Q000378:metabolism*; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000378:metabolism; D010710:Phosphates / Q000378:metabolism; D011446:Prospective Studies; D020123:Sirolimus / Q000494:pharmacology*
D007166:Immunosuppressive Agents; D010281:Parathyroid Hormone; D010710:Phosphates; D003404:Creatinine; D002118:Calcium; D020123:Sirolimus