Improvement of Cardiovascular Risk Factors and Cosmetic Side Effects in Kidney Transplant Recipients After Conversion to Tacrolimus

Zadrazil, J; Horák, Pavel; Zahálková, J; Štrebl, Pavel; Horčička, Vladko; Krejčí, Karel; Bachleda, Petr; Dedochova, Jarmila; Valkovský, Ivo

doi:10.5507/bp.2009.012

Cited by 7 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regardless of interval glucocorticoid exposure and BMI-Z, treatment with cyclosporine versus tacrolimus was associated with higher SBP-Z and DBP-Z. These findings are consistent with other studies in renal and other solid organ transplant recipients demonstrating a greater burden of hypertension with cyclosporine compared with tacrolimus immunosuppression [49][50][51].…”

Section: Discussionsupporting

confidence: 91%

Longitudinal relations between obesity and hypertension following pediatric renal transplantation

et al. 2010

View full text Add to dashboard Cite

Obesity and hypertension frequently complicate renal transplantation (RTxp). The objective was to assess relations among obesity, hypertension, and glucocorticoids in pediatric RTxp recipients. A retrospective cohort study was carried out in 141 RTxp recipients, 2-21 years of age, with >or=12 months of follow-up. Body mass index Z-score (BMI-Z), systolic and diastolic blood pressure Z-scores (SBP-Z and DBP-Z), and medications at 1, 3, 6, and 12 months and annually thereafter were recorded. Quasi-least squares regression analysis was used. The prevalence of obesity (BMI>or=95th percentile) increased from 13% at baseline to >30% from 3 months onward. Greater glucocorticoid exposure (mg/kg/day) was associated with greater increases in BMI-Z (p<0.001). This association was greater in males, younger recipients, and those with lower baseline BMI-Z (all interactions p<0.02). The prevalence of systolic hypertension (SBP>or=95th percentile) was 73% at 1 month and >or=40% at all follow-up visits. Greater glucocorticoid exposure (p<0.001) and increases in BMI-Z (p=0.005) were independent determinants of SBP-Z over time. Cyclosporine (versus tacrolimus) was independently associated with greater SBP-Z and DBP-Z (p=0.001). Sustained obesity and hypertension frequently complicated pediatric RTxp. Obesity was an independent determinant of systolic hypertension. Strategies are needed to prevent obesity and its impact on hypertension, cardiovascular disease, and allograft survival.

show abstract

Section: Discussionsupporting

confidence: 91%

Longitudinal relations between obesity and hypertension following pediatric renal transplantation

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Previous studies in renal transplant recipients demonstrated that conversion from CS to TAC immunosuppression reduces the progression of chronic kidney disease (CKD) 11–13 . This may be attributed to a lower expression of profibrotic genes, such as transforming growth factor (TGF)‐beta I and fewer adverse effects on renal haemodynamics in TAC‐treated patients 14–16 .…”

Section: Introductionmentioning

confidence: 99%

Renal function and cardiovascular risk profile after conversion from ciclosporin to tacrolimus: prospective study in 80 liver transplant recipients

Beckebaum

Klein²,

Varghese³

et al. 2009

Aliment Pharmacol Ther

View full text Add to dashboard Cite

show abstract

“…There are also differences in the non-renal toxic effects of cyclosporine versus tacrolimus 71 which often influence the choice of CI in a particular patient. Post-transplant diabetes mellitus, neurotoxicity, cephalea, diarrhea, and hypomagnesemia were observed more commonly after tacrolimus treatment.…”

Section: Comparison Of Toxic Effects Of Both CImentioning

confidence: 99%

Calcineurin Inhibitor-Induced Renal Allograft Nephrotoxicity

Krejčí¹,

Tichý²,

Bachleda³

et al. 2010

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

Self Cite

View full text Add to dashboard Cite

Background. The introduction of the calcineurin inhibitors (CI) cyclosporine and tacrolimus into immunosuppressive protocols initiated a new era in organ transplantation with excellent short-term graft survival. Nevertheless, the chronic nephrotoxicity of these drugs represents a significant adverse factor limiting their long-term use. Patients treated with a CI can be at risk for developing renal failure and this problem is especially pronounced in patients after renal transplantation.Methods and Results. In a review paper we summarize the clinical aspects, histological manifestations and pitfalls of diagnostics of acute and chronic CI nephrotoxicity in patients after kidney transplantation. We look in detail at the disputed relationship between blood concentrations of cyclosporine and tacrolimus and histological manifestation of toxicity and summarize data showing that for toxic effects, local renal exposure to CI and their metabolites can play a more significant role than systemic exposure. We also include recent views on the pathophysiologic and molecular mechanisms underlying these changes; factors influencing local susceptibility to CI nephrotoxicity are discussed, including variability of expression and activity of P-glycoprotein and cytochrome P450. Last but not least we summarize our own experience with clinically manifest and subclinical forms of nephrotoxicity and their impact on the progression of chronic graft changes.Conclusions. Owing to their unique effects, CI remain the cornerstone of most immunosuppressive protocols for renal transplantation. Together with optimization of local kidney exposure to CI and their metabolites, efforts to reduce systemic levels as much as possible are the most important preventive measure for reducing toxic renal graft damage.

show abstract

Improvement of Cardiovascular Risk Factors and Cosmetic Side Effects in Kidney Transplant Recipients After Conversion to Tacrolimus

Cited by 7 publications

References 32 publications

Longitudinal relations between obesity and hypertension following pediatric renal transplantation

Longitudinal relations between obesity and hypertension following pediatric renal transplantation

Renal function and cardiovascular risk profile after conversion from ciclosporin to tacrolimus: prospective study in 80 liver transplant recipients

Calcineurin Inhibitor-Induced Renal Allograft Nephrotoxicity

Contact Info

Product

Resources

About