The effect of calcineurin inhibitors on endothelial function in renal transplant recipients

: Endothelial dysfunction is of vital importance, as it may cause ischemia and dysfunction in various organs. Despite, this problem has been well documented in patients with end‐stage renal disease (ESRD), there is not enough data considering this issue following renal transplantation. One of the p...

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Published in:	Clinical transplantation Vol. 17; no. 3; pp. 212 - 216
Main Authors:	Oflaz, Huseyin, Turkmen, Aydin, Kazancioglu, Rumeyza, Kayacan, Seyit M, Bunyak, Banu, Genchallac, Hakan, Erol, Bulent, Mercanoglu, Fehmi, Umman, Sabahattin, Sever, Mehmet S
Format:	Journal Article
Language:	English
Published:	Oxford, UK Munksgaard International Publishers 01-06-2003 Blackwell
Subjects:	Adult Biological and medical sciences Brachial Artery - diagnostic imaging Brachial Artery - drug effects Calcineurin Inhibitors cyclosporine Cyclosporine - therapeutic use endothelial function Endothelium, Vascular - diagnostic imaging Endothelium, Vascular - drug effects Endothelium, Vascular - physiology Female Humans Immunomodulators Immunosuppressive Agents - therapeutic use Kidney Transplantation - physiology Male Medical sciences Pharmacology. Drug treatments renal transplantation tacrolimus Tacrolimus - therapeutic use Ultrasonography Vasodilation - drug effects Kidney disease Human cyclosporine endothelial function Endothelial cell Urinary system disease Calcineurin Treatment efficiency renal transplantation Transplantation Kidney Prevention Rejection Chemotherapy Treatment Tacrolimus Surgery Graft Ciclosporin Inhibitor Immunosuppressive agent
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Summary:	: Endothelial dysfunction is of vital importance, as it may cause ischemia and dysfunction in various organs. Despite, this problem has been well documented in patients with end‐stage renal disease (ESRD), there is not enough data considering this issue following renal transplantation. One of the potential causes of endothelial dysfunction in renal transplant recipients may be administration of calcineurin inhibitors. The aim of this study is to evaluate the effects of two different calcineurin inhibitors [cyclosporin A (CsA) and tacrolimus (FK506)] on endothelial function in renal transplant patients. Forty‐four renal transplant recipients [22 on FK506 (group I) and 22 on CsA (group II)] were studied. Endothelial functions of the brachial artery were evaluated by using high resolution vascular ultrasound. Endothelium‐dependent and ‐independent vasodilations were assessed by establishing reactive hyperemia and using sublingual nitroglycerine (NTG), respectively. Results are presented as percentage change from baseline values. Significant endothelial dysfunction was noted in renal transplant patients treated with CsA. While endothelium‐dependent vasodilation was 12.1 ± 5.1% in group I and it was 6.5 ± 3.7% in group II (p < 0.001). The increase in brachial artery diameter after sublingual NTG was 20.1 ± 6.3 and 12.7 ± 5.6% in groups I and II, respectively. This indicates that the endothelium‐dependent and ‐independent vasodilation of the patients on FK506 is better preserved than the patients on CsA therapy. Besides, blood flow volume (BFV) increase was 51.2 ± 39.4 and 43.9 ± 24.3%, in groups I and II, respectively, in reactive hyperemia period (p > 0.05). Post‐transplant course of renal transplant recipients is complicated by endothelial dysfunction. This problem is more prominent in patients on CsA therapy, which can predispose these patients to more frequent cardiac complications.
Bibliography:	istex:4A09430FB91A25E317B49D43310D0579506D5329 ark:/67375/WNG-KTZZB1BS-S ArticleID:CTR030 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0902-0063 1399-0012
DOI:	10.1034/j.1399-0012.2003.00030.x