Korean J Nephrol.  2008 May;27(3):358-363.

The Effect of Conversion from Cyclosporine to Tacrolimus in Renal Allograft Recipient with Hyperlipidemia

• Park JE
• Choi SY
• Park MN
• Jung KH
• Moon JY
• Lee SH
• Ihm CG
• Lee TW

Abstract

PURPOSE
Management of cardiovascular risk factors is of major importance in renal transplant recipients to determine long-term outcomes. While calcineurin inhibitors improve the clinical course after kidney transplantation, they have been implicated in contributing to increased cardiovascular risk. This study investigated the influence of conversion from cyclosporine to tacrolimus on cardiovascular risks and graft function in renal allograft recipients with hyperlipidemia.
METHODS
Twenty three adult renal recipients who were receiving cyclosporine-based regimen for more than one year after transplantation and had hyperlipidemia (serum total cholesterol > or =200 mg/dL) were enrolled. The effect of conversion from cyclosporine to tacrolimus was evaluated with blood pressure, fasting lipid profile, glucose and HbA1c. They were measured at baseline and at 1, 3, 6 and 12 months after conversion. The change in estimated glomerular filtration rate (eGRF) was also compared between before and after conversion.
RESULTS
Though conversion from cyclosporine to tacrolimus did not cause significant differences in the serum triglyceride level, there was a noticeable decline in total cholesterol level (213.78+/-16.28 to 185.96+/-38.62 mg/dL, p<0.01). Conversion did not trigger new onset or worsening of diabetes mellitus with no meaningful differences in fasting blood glucose and HbA1c levels. The eGFR stabilized with Tacrolimus in comparison with the cyclosporine (-2.9+/-13.4 mL/min vs. -7.3+/-13.8 mL/min).
CONCLUSION
Conversion to tacrolimus would be preferable to cyclosporine for maintenance immunesuppression in renal recipient with hyperlipidemia, as it meliorates hyperlipidemia and leads to stabilization of allograft function.

Keyword

Tacrolimus; Cardiovascular disease; Dyslipidemia; Cyclosporine; Kidney transplantation

MeSH Terms

Adult
Blood Glucose
Blood Pressure
Calcineurin
Cardiovascular Diseases
Cholesterol
Cyclosporine
Diabetes Mellitus
Dyslipidemias
Fasting
Glomerular Filtration Rate
Glucose
Humans
Hyperlipidemias
Kidney Transplantation
Risk Factors
Tacrolimus
Transplantation, Homologous
Transplants
Blood Glucose
Calcineurin
Cholesterol
Cyclosporine
Glucose
Tacrolimus