NDT Advance Access published online on June 8, 2004
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh344
© 2004 by European Renal Association - European Dialysis and Transplant Association
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Department of Emergency and Organ Transplantation, Division of Nephrology, University of Bari, Bari, Italy
* To whom correspondence should be addressed. E-mail: s.dipaolo{at}nephro.uniba.it.
Background. Cyclosporin (CsA) level obtained 2 h after the morning dose (C2) has been shown to accurately predict total CsA exposure and acute rejection (AR) risk, whereas conventional trough levels (C0) do not. The impact of C2 monitoring on long-term kidney graft function, independent from AR risk, is still unclear, however, and it was assessed in the present study. Methods. We enrolled 39 CsA-treated renal transplant recipients and used 1 year graft function and histological structure as surrogate markers of graft outcome. CsA dose was adjusted according to C2 levels. Results. In the first 7 days after grafting, 40-51% of patients failed to reach target C2 levels; nevertheless, at 1 year the incidence of AR was only 2.5% and graft and patient survival was 100%. The decrease of serum creatinine (12-6 months) was associated with significantly higher C2 levels over time (P = 0.0003) and lower intrapatient variability of CsA relative absorption (CV) (P = 0.0006). One year graft biopsy showed chronic tubulointerstitial lesions in 54.5% of patients. Both C2 mean levels and the percentage CV independently predicted the severity of chronic histological lesions (R = 0.69, P<0.0001). Conclusions. Higher C2 levels, within the proposed target range values, seem to be associated with better renal function and structure.
Accepted May 6, 2004
Original Article
Cyclosporin exposure correlates with 1 year graft function and histological damage in renal transplanted patients
2 Department of Emergency and Organ Transplantation, Division of Urology, University of Bari, Bari, Italy
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Naesens, D. R. J. Kuypers, and M. Sarwal Calcineurin Inhibitor Nephrotoxicity Clin. J. Am. Soc. Nephrol., February 1, 2009; 4(2): 481 - 508. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. M. Scholten, A. T. Rowshani, S. Cremers, F. J. Bemelman, M. Eikmans, E. van Kan, M. J. Mallat, S. Florquin, J. Surachno, I. J. ten Berge, et al. Untreated Rejection in 6-Month Protocol Biopsies Is Not Associated with Fibrosis in Serial Biopsies or with Loss of Graft Function J. Am. Soc. Nephrol., September 1, 2006; 17(9): 2622 - 2632. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Stoves, R. Baker, and C. G. Newstead Measurement of cyclosporin exposure in renal transplant recipients during the early post-operative period: is C2 alone sufficient? Nephrol. Dial. Transplant., April 1, 2005; 20(4): 854 - 855. [Full Text] [PDF]
|
|