13th Congress of the Polish Society of Transplantation: Part IKidney transplantationCardiovascular Disease in Kidney Transplantation and Its Association With Blood Concentrations of Cyclosporine and Cyclosporine Metabolites
Section snippets
Methods
This was an open trans-sectional one-center study including kidney transplant patients taking cyclosporine as an element of their immunosuppressive regimen. Sixty consecutive KTX patients attending the outpatient clinic from May 2014 to April 2016 who agreed to participate in the study were included. Blood samples for CsA and its metabolites were drawn in occasions of routine blood testing 12 hours after administration of the evening dose of CsA (through levels). Graft function was assessed by
Results
Among the patients, 36.67% (22) were women, median age 51.73 (12.05) years, 109.38 (68.26) months after kidney transplantation. Table 1 shows the patients' clinical data. In univariate analyses, we have observed significant positive correlations of diastolic blood pressure with metabolite to parent drug (M/D) cyclosporine ratios of AM1, DiH-CsA, TriH-CsA, and dMC-CsA (Fig 1). There were no such correlations with systolic blood pressure and eGFR values, nor correlation of DBP with CsA blood
Discussion
It is hypothesized that approximately 65% of cyclosporine may be present in the blood in the form of various metabolites [10]. The search for causes of cyclosporine toxicity has led to increased interest in CsA metabolites [11], [12], [13], [14], [15]. In the early 1990s the immunosuppressive and toxic actions of cyclosporine metabolites were studied extensively, but the results were mostly inconclusive or contradictory [4], [14], [16], [17], [18], [19]. It should also be emphasized that
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2021, Clinica Chimica ActaCitation Excerpt :For example, cyclosporine, by binding to hepatic LDLR and inhibiting LDL uptake by hepatocytes, induces a dose-dependent significant increase in serum total cholesterol and LDL-C levels and a drop in serum HDL-C levels. Corticoids have also been confirmed to induce dyslipidemia by promoting the hepatic synthesis of lipids, especially facilitating VLDL production as well as diminishing the hepatic uptake of LDL-C [66]. Noticeably, two novel medicines, tacrolimus and azathioprine, have been recently provided to induce less important alterations of the lipid profiles, which could be considered for replacement of the more harmful cyclosporine [67].
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This work was supported by the Polish National Science Centre (grant 2013/09/B/NZ2/00275) and the Polish National Centre of Research and Development (grant NR13014410).