Conversion from cyclosporine microemulsion (CyA-Me) to tacrolimus (TAC) in kidney allograft recipients

Background: Available data suggests that cyclosporin and tacrolimus differ in respect of nephrotoxicity and long term graft function in kidney transplantation. The aim of this study was to evaluate the impact of converting stable kidney allograft recipients from CyA-Me to TAC on renal function and cardiovascular risk profile.
Material/Methods: 31 patients with stable renal function (Scr <3.0 mg/dl) were successfully switched from CyA-Me to TAC and followed up for 24 months. Majority (77.4%) had suspicion of CyA nephrotoxicity. Renal function was measured as serum creatinine (Scr) and calculated GFR. Office blood pressure and lipid profiles were evaluated.
Results: 29 patients fi nished the 24 month observation period. 1 and 2 year patient's survival was 100%; graft's survival was 93.5% and 91% respectively. No new cases of diabetes mellitus were identified. Mean SCr fell from 2.28±0.4 to 1.95±0.4 mg/dl (P<.02) and calculated GFR increased from 49.1±15 to 55.2±16 mL/min (P<.05). Total cholesterol decreased from 236±50 to 190±31 mg/dL (P <.02), LDL cholesterol from 132±36 to 105±23 mg/dL (P<.02). No significant changes in mean systolic or diastolic pressure were observed although numerically both systolic and diastolic BP had tendency to fall. Blood glucose levels were unchanged.
Conclusions: Our results show that this group of patients with increased creatinine at entry conversion to TAC resulted in improved graft function and more favourable cardiovascular risk profile, which may result in longer graft halflife, but the observation period was too short to confi rm such statement.

Keywords: Kidney Transplantation