Nephrol Dial Transplant (2000) 15: 311-314
© 2000 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Renal failure following cardiac transplantation
1 Division of Nephrology and 2 Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden
Correspondence and offprint requests to: Dr Hans Herlitz, Dept of Nephrology, Sahlgrenska University Hospital, S-41345, Göteborg, Sweden.
Introduction
The clinical outcome of cardiac transplantation has markedly improved over the last two decades due to the introduction of cyclosporin therapy. However, the renal side-effects of cyclosporin appear to be a major drawback to its use. The early studies by Myers et al. [1] described the renal structural and functional changes in the native kidneys of heart transplant recipients. Repeated haemodynamic investigations revealed a progressive decrease in glomerular filtration rate (GFR), a concomitant drop in renal plasma flow, and an increase in renal vascular resistance associated with systemic hypertension. Renal biopsies in a subset of patients disclosed glomerulosclerosis, striped interstitial fibrosis, and afferent arteriolopathy. In the original study a high starting dose of cyclosporin was used (17 mg/kg), which was later decreased to 10 mg/kg. However, when these two groups were compared, both of them had developed hypertension and a decreased GFR. Even with a low dose of
Long-term studies on renal function
Cyclosporin-induced renal injury
Preventive measures
References
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