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KMID : 0370220170610030164
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Yakhak Hoeji
2017 Volume.61 No. 3 p.164 ~ p.170
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Comparison of Laboratory Values and Adverse Effects between Cyclosporineand Tacrolimus-based Regimens in Renal Transplant Patients: 12-month Follow-up Results at a Tertiary Teaching Hospital
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Kim Hae-Jeong
Yang Young-Mo
Choe In
Choi Eun-Joo
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Abstract
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Multidrug combination of immunosuppressive agents has been used to achieve an optimal immunosuppression and prevent adverse effects (AEs) of immunosuppressant in kidney transplant patients. Cyclosporine (CsA) and tacrolimus (TAC) are mostly used immunosuppressive drugs out of preferred immunosuppressive regimens for the prevention of rejection after kidney transplantation. Due to variable pharmacokinetic profiles and frequent AEs with immunosuppressants such as CsA, TAC, and mycophenolate mofetil (MMF), the studies related to therapeutic drug monitoring (TDM) of immunosuppressive regimen have continuously been researched. The aims of this study were to analyze monitoring and AEs on IMRs in renal transplant patients. The study was conducted at the teaching hospital in Gwangju, Korea. Medical charts of 58 renal transplant patients selected based on inclusion criteria between January 2002 and July 2013 were reviewed retrospectively. Among total 58 patients, 38 were included in the analysis. They were divided into two groups: CsA +MMF + steroid group (CsA group, n=28) and TAC +MMF + steroid (TAC group, n=10) group. As a result, the triglyceride level of the CsA group was significantly increased compared with that of the TAC group at 3, 9 and 12 months (p=0.008, p=0.007, p=0.033, respectively). The dyslipidemia complications of CsA group were higher than that of TAC group at 3, 6, and 12 month after transplantation (p=0,044, p=0.043, p=0.048, respectively). The AST level of CsA group was significantly increased compared with that of the TAC group at 3 month (p=0.002). This study also showed that a TAC-based regimen tended to increase a blood glucose level during 12 months. This study determined that patients with a CsA-based regimen should be closely monitored regarding lipid profiles and liver function tests, and those with a TAC-based regimen should be cautiously monitored about blood glucose levels to prevent complications by AEs during immunosuppressive therapy.
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KEYWORD
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Immunosuppressive Agents, Monitoring Factors, Adverse Effects, Kidney Transplantation
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