title: Relationship between hemorheology and endothelial dysfunction in renal transplant patients receiving calcineurin inhibitors.
abstract: BACKGROUND
  Calcineurin inhibitors, mainly cyclosporin A (CsA), are associated with endothelial dysfunction in renal transplant recipients (RTRs). Hemorheological disturbances including decreased erythrocyte deformability (ED), increased plasma viscosity and erythrocyte aggregation (EA) have also been reported in CsA-treated RTRs. The aim of this study was to investigate the relationship between hemorheological factors and endothelial dysfunction in CsA- and tacrolimus (Tc)-treated RTRs.
  
  
  METHODS
  Thirty-one RTRs and 16 healthy subjects were recruited. The RTR group received either CsA (n = 16) or Tc (n = 15). Endothelial function was evaluated by flow-mediated dilation (FMD) of the brachial artery. ED and EA were measured with laser-assisted optical rotational cell analyzer, and plasma viscosity by a cone-plate viscometer.
  
  
  RESULTS
  FMD of the CsA group was significantly lower than that of controls (6.3% ± 5.1% vs. 11.9% ± 5.6%, p = 0.024), whereas, there was no significant difference between the Tc group (8.8% ± 5.4%) and controls. At shear stresses ranging between 0.95 and 30 Pa, EDs of the CsA group were significantly lower compared with controls. In the Tc group, the decrease in ED was significant at shear stresses ranging between 0.53 and 5.33 Pa. ED indices did not correlate with FMD in any of the groups.
  
  
  CONCLUSIONS
  The degree of endothelial dysfunction and reduction in ED were more remarkable in patients on CsA therapy. Hemorheological factors were not likely to be associated with endothelial dysfunction in RTRs.
authors.affiliation: Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara - Turkey.
authors.forename: Hadim
authors.initials: H
authors.lastname: Akoglu
authors.forename: Nurten
authors.initials: N
authors.lastname: Seringec
authors.forename: Tolga
authors.initials: T
authors.lastname: Yildirim
authors.forename: Rahmi
authors.initials: R
authors.lastname: Yilmaz
authors.forename: Sercan
authors.initials: S
authors.lastname: Okutucu
authors.forename: Ercan
authors.initials: E
authors.lastname: Turkmen
authors.forename: Banu
authors.initials: B
authors.lastname: Evranos
authors.forename: Ergun B
authors.initials: EB
authors.lastname: Kaya
authors.forename: Neslihan
authors.initials: N
authors.lastname: Dikmenoglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Arici
authors.forename: Yunus
authors.initials: Y
authors.lastname: Erdem
authors.forename: Cetin
authors.initials: C
authors.lastname: Turgan
mesh_terms: D000328:Adult; D001809:Blood Viscosity / Q000187:drug effects; D001916:Brachial Artery / Q000187:drug effects / Q000503:physiopathology; D065095:Calcineurin Inhibitors / Q000009:adverse effects*; D016022:Case-Control Studies; D016572:Cyclosporine / Q000009:adverse effects; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D004903:Erythrocyte Aggregation / Q000187:drug effects; D004907:Erythrocyte Deformability / Q000187:drug effects; D005260:Female; D018056:Hemorheology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D018709:Statistics, Nonparametric; D016559:Tacrolimus / Q000009:adverse effects; D014652:Vascular Diseases / Q000503:physiopathology*; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology
chemical_list: D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus