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KMID : 0359920070260050610
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Korean Journal of Nephrology
2007 Volume.26 No. 5 p.610 ~ p.618
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Comparison of Cardiovascular Risk Profiles and Graft Function between Cyclosporin A-based and Tacrolimus-based Immunosuppression in Renal Transplant Recipients
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Choi Ji-Young
Jin Mi-Kyung
Chun Joo-Hyun
Hyun Seung-Hyea
Hur In-Kyong
Lee Eun-Young
Cho Ji-Hyung
Park Sun-Hee
Kim Yong-Lim
Kim Chan-Duck
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Abstract
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Purpose : Tacrolimus (TAC) may be less unfavorable than cyclosporin A (CsA) on cardiovascular morbidity and mortality in renal transplant recipients, but well controlled studies are insufficient.
Methods : In this prospective randomized controlled study, fifty seven consecutive renal transplant recipients were treated with CsA-based (CsA, MMF and steroid, CsA group: n=27) or TAC-based (TAC, MMF and steroid, TAC group: n=30) immunosuppressive regimens by randomized ratio of 1:1. In the baseline (pre-operation), 1, 3, and 6 months after transplantation, several cardiovascular risk factors and graft function were evaluated.
Results : There were no significant differences in the renal function, glucose regulation, the incidence of acute rejection and post-transplant diabetes mellitus for the post-transplant 6 months between the two groups. The blood pressure of the CsA group was maintained higher than TAC group through 6 months after transplantation even though the number of antihypertensive drugs in the CsA group was significantly higher at 3 and 6 month after transplantation. The lipid profiles except oxidized LDL were similar, but oxidized LDL level was significantly higher for the post-transplant 6 months in the CsA group (p<0.05). There were no significant differences in levels of fibrinogen, PAI-I, t-PA, hs-CRP, homocysteine, spot urine TGF-βaand βig-h3, but the uric acid level was significantly higher in the CsA group (p<0.05).
Conclusion : This study demonstrates that TAC tends to have a beneficial effect on cardiovascular risk profiles, with regard to BP and atherogenic properties of serum lipids in early post-transplant period.
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KEYWORD
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Cyclosporine, Tacrolimus, Cardiovascular system, Graft survival
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