Korean J Nephrol.  2007 Sep;26(5):610-618.

Comparison of Cardiovascular Risk Profiles and Graft Function between Cyclosporin A-based and Tacrolimus-based Immunosuppression in Renal Transplant Recipients

• Choi JY
• Jin MK
• Chun JH
• Hyun SH
• Hur IK
• Lee EY
• Cho JH
• Park SH
• Kim YL
• Kim CD

Abstract

PURPOSE: Tacrolimus (TAC) may be less unfavorable than cyclosporin A (CsA) on cardiovascular morbidity and mortality in renal transplant recipients, but well controlled studies are insufficient.
METHODS
In this prospective randomized controlled study, fifty seven consecutive renal transplant recipients were treated with CsA-based (CsA, MMF and steroid, CsA group: n=27) or TAC-based (TAC, MMF and steroid, TAC group: n=30) immunosuppressive regimens by randomized ratio of 1:1. In the baseline (pre-operation), 1, 3, and 6 months after transplantation, several cardiovascular risk factors and graft function were evaluated.
RESULTS
There were no significant differences in the renal function, glucose regulation, the incidence of acute rejection and post-transplant diabetes mellitus for the post-transplant 6 months between the two groups. The blood pressure of the CsA group was maintained higher than TAC group through 6 months after transplantation even though the number of antihypertensive drugs in the CsA group was significantly higher at 3 and 6 month after transplantation. The lipid profiles except oxidized LDL were similar, but oxidized LDL level was significantly higher for the post-transplant 6 months in the CsA group (p<0.05). There were no significant differences in levels of fibrinogen, PAI-I, t-PA, hs-CRP, homocysteine, spot urine TGF-beta a and beta ig-h3, but the uric acid level was significantly higher in the CsA group (p<0.05).
CONCLUSION
This study demonstrates that TAC tends to have a beneficial effect on cardiovascular risk profiles, with regard to BP and atherogenic properties of serum lipids in early post-transplant period.

Keyword

Cyclosporine; Tacrolimus; Cardiovascular system; Graft survival

MeSH Terms

Antihypertensive Agents
Blood Pressure
Cardiovascular System
Cyclosporine*
Diabetes Mellitus
Fibrinogen
Glucose
Graft Survival
Homocysteine
Immunosuppression*
Incidence
Mortality
Prospective Studies
Risk Factors
Tacrolimus
Transforming Growth Factor beta
Transplantation*
Transplants*
Uric Acid
Antihypertensive Agents
Cyclosporine
Fibrinogen
Glucose
Homocysteine
Tacrolimus
Transforming Growth Factor beta
Uric Acid