Effects of Calcium Channel Blocker In Renal Allograft Recipients Receiving Cyclosporine

Kwun, Oh Soo; Suh, Bo Yang; Kwun, Koing Bo

Abstract

Calcium channel blockers are used for the management of hypertension or heart disease after organ transplantation and are known to increase in blood cyclosporine A(CsA) levels through an effect on the hepatic cytochrome P450 system resulting in reduced CsA clearance. Authors reviewed and analyzed 154 CsA-treated renal allograft recipients at Yeungnam University Hospital from Mar. 1985 to Mar. 1996 to evaluate the effects of calcium antagonists on renal recipient. Among 154 recipients, 60 recipients were received triple immunosuppressive drugs (CsA+Prednisolone+ Azathioprine) only (Control group), 43 recipients with diltiazem (D group) and 51 recipients with Nifedipine (N group). Blood pressure(systolic and diastolic), creatinine level, CsA blood level and CsA dose had been checked at 1 week, 1, 3, 6, 9 and 12 months, after renal transplantation serially and compared the results with each groups. CsA blood levels of all groups had been adjusted to 100-150 ng/ml after 3 month of immunosuppression. There was no difference in CsA blood levels among 3 groups at all follow-up periods. Dose reduction of CsA had been noted 18%, 27%, 29%, 32%, and 28% in D group at 1, 3, 6, 9 and 12 months respectively(p<0.05), In N group, CsA dose reduction had been noted 7%, 6%, 3%, 11% and 5% at 1, 3, 6, 9 and 12 months, but this results was not significant statistically(p>0.05). Incidence of primary nonfunction, graft loss, acute rejection, chronic rejection and CsA nephrotoxicity were not different statistically among 3 groups. In conclusion, the use of diltiazem was associated with a markedly reduced requirement for CsA without any adverse effect on graft function or graft outcome. but the use of nifedipine may not associated with repuirement for CsA statistically.