Time Course of the Decline in Renal Function in Cyclosporine-Treated Heart Transplant Recipients
作者:
Robert Zietse,
Aggie H. Balk,
Marinus A.v.d. Dorpel,
Karin Meeter,
Egbert Bos,
Willem Weimar,
期刊:
American Journal of Nephrology
(Karger Available online 1994)
卷期:
Volume 14,
issue 1
页码: 1-5
ISSN:0250-8095
年代: 1994
DOI:10.1159/000168677
出版商: S. Karger AG
关键词: Cyclosporine;Renal failure;Heart transplantation
数据来源: Karger
摘要:
The renal side-effects are a major limitation of the use of cyclosporine A (CsA) following heart transplantation. In an effort to define the time course of the decline in renal function and to identify a group of patients especially prone to the nephrotoxic effects of CsA, we studied 187 orthotopic heart transplant recipients who had a follow-up of at least 1 month. All patients received oral CsA in a starting dose of 8 mg/kg and low-dose steroids. Renal function decreased steadily after transplantation. Serum creatinine was > 150 µmol/l in 52% of the patients after 2 years. After 4 years serum creatinine was > 250 µmol/l in 13% of the patients. No relation could be found between the decline in renal function (as defined by the slope of serum creatinine-1 versus time) and age, sex, creatinine levels before transplantation, blood pressure, CsA blood levels, the number of rejections or the use of calcium channel blocking drugs. We conclude that, despite reduction of CsA dosage, progressive renal insufficiency can be observed in an increasing percentage of heart tansplant recipients. We were not able to identify patients with a poor renal prognosis in an early phase after transplantatio
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