Nephrology Dialysis Transplantation, Vol 13, Issue 9 2327-2334, Copyright © 1998 by Oxford University Press
J Madsen, S Sorensen, H Hansen and E Pedersen
Background: Due to their vasodilatory effect, calcium
antagonist may have a renoprotective against cyclosporin (CsA)-induced
nephrotoxicity and rise in blood pressure (BP) seen in renal
transplantation. Methods: In order to evaluate the
effect of the calcium antagonist felodipine on renal function and BP during
cyclosporin treatment, 79 CsA-treated renal transplant recipients were
investigated during the first 3 months after transplantation in a
randomized, double-blind, placebo-controlled study with two parallel
groups. Felodipine (ER tablets, 10 mg) or placebo was given prior to
transplantation and each day during the study period. The patients were
assessed twice, i.e. at 4-6 weeks and at 10-12 weeks after transplantation.
Renal plasma flow (RPF) and glomerular filtration rate (GFR) were measured
by constant infusion technique. Tubular function was estimated from
clearance of lithium. Results: At 6 weeks after
transplantation, felodipine caused a significantly higher RPF [felodipine:
219±70 ml/min; placebo: 182±56 ml/min
(mean±1 SD); P=003]. No differences were found in GFR,
filtration fraction (FF), tubular sodium handling, or sodium excretion.
Felodipine lowered BP significantly. At 12 weeks after transplantation,
felodipine caused a significantly higher GFR (felodipine; 49±18
ml/min; placebo: 40±16 ml/min; P=0.05) and RPF (felodipine:
225±77 ml/min; placebo: 175±48 ml/min;
P<0.01). No difference was found in FF. Felodipine lowered BP
significantly. No differences were found with regard to duration of primary
anuria, hospitalization time; number of rejection episodes, plasma
creatinine day 7 post-transplant, or treatment doses of CsA.
Conclusions: It is concluded that in renal transplant
recipients treated with CsA, felodipine significantly increased both GFR
and RPF 3 months after transplantation when compared with placebo, despite
a concomitant lowering of BP. A possible antagonizing affect of felodipine
against CsA-induced nephrotoxicity in these patients is suggested.
Key words: cyclosporin; felodipine; glomerular
filtration rate; hypertension; renal plasma flow; renal transplant
ORIGINAL ARTICLES
The effect of felodipine on renal function and blood pressure in cyclosporin-treated renal transplant recipients during the first three months after transplantation
Research Laboratory of Nephrology and Hypertension, Department of Medicine and Nephrology C, Skejby Hospital, Aarhus University Hospital, Aarhus amtssygehus, DK-800 Aarhus C, Denmark; Corresponding author
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