Tacrolimus (T) is largely used in kidney transplantation (KTx). Beside its efficacy, T causes several well recognized side effects such hypertension, nephrotoxicity, neurotoxicity, diabetes. The effects of T on lipid profile are not yet well evaluated lacking studies in KTx with adequate population and/or long-lasting follow-up. Since dyslipoproteinemia is present in 50-70% patients after KTx and cardiovascular events are still the major cause of death, in this study the effects of T on lipids were investigated. Transplanted Pts (n.35; n.29 males, 6 female; mean age 48 ± 2.1 SD, years) were enrolled. Concomitant therapy was: steroids (n.35), azathioprine (n.22), mycophenolate mofetil (n.2). Pts were evaluated 1, 3, 6, 12, 18, 24, 36 months after T treatment. At these study periods total cholesterol (C), tryglicerides (TG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL) and very low density lipoprotein cholesterol (VLDL) were assayed and T blood trough concentrations determined. The values found at all follow-up study periods values were compared with those of 1stmonth of treatment (Student’s test; ANOVA for repeated measures). Mean dose of T was 0.11 ± 0.08 mg/kg/die; mean serum T concentration was 9.9 ± 4.2 ng/ml. Mean dose of steroids and azathioprine was 10 ± 4.4 and 65 ± 18 mg/day, respectively). C (202±48 mg/dL), TG (139±41 mg/dL), HDL (49±13 mg/dL), LDL (123±42 mg/dL), VLDL (28±7 mg/dL) were not affected by T throughout the study as well as plasma sodium and serum potassium. Drawbacks were not observed; thus no patients gave up the medication because of side effects. No liver or bone marrow alteration were found. No increase of rejection rate was observed. In conclusion T does not affect lipids in patients with KTx even after long lasting follow-up (36 months). Thus T should be preferred to other immunosuppressive agents in high-risk patients to reduce the incidence of cardiovascular events. Keywords: FK-506; transplant: outcome; transplant: complications; transplant: rejection, chronic
TACROLIMUS AND LIPIDS IN KIDNEY TRANSPLANTATION. LONG TERM FOLLOW-UP / Palmiero, Giuseppe; Capone, Domenico; Balletta, MARIO MARIA; Federico, Stefano; Sirico, Marialuigia; Amato, Mariangela; Russo, Domenico. - In: NEPHROLOGY DIALYSIS TRANSPLANTATION. - ISSN 1460-2385. - (2003). (Intervento presentato al convegno World Congress of Nephrology Berlin 8-12 june-2003 tenutosi a Berlin nel 8-12 june-2003).
TACROLIMUS AND LIPIDS IN KIDNEY TRANSPLANTATION. LONG TERM FOLLOW-UP
CAPONE, DOMENICO;BALLETTA, MARIO MARIA;FEDERICO, STEFANO;RUSSO, DOMENICO
2003
Abstract
Tacrolimus (T) is largely used in kidney transplantation (KTx). Beside its efficacy, T causes several well recognized side effects such hypertension, nephrotoxicity, neurotoxicity, diabetes. The effects of T on lipid profile are not yet well evaluated lacking studies in KTx with adequate population and/or long-lasting follow-up. Since dyslipoproteinemia is present in 50-70% patients after KTx and cardiovascular events are still the major cause of death, in this study the effects of T on lipids were investigated. Transplanted Pts (n.35; n.29 males, 6 female; mean age 48 ± 2.1 SD, years) were enrolled. Concomitant therapy was: steroids (n.35), azathioprine (n.22), mycophenolate mofetil (n.2). Pts were evaluated 1, 3, 6, 12, 18, 24, 36 months after T treatment. At these study periods total cholesterol (C), tryglicerides (TG), high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL) and very low density lipoprotein cholesterol (VLDL) were assayed and T blood trough concentrations determined. The values found at all follow-up study periods values were compared with those of 1stmonth of treatment (Student’s test; ANOVA for repeated measures). Mean dose of T was 0.11 ± 0.08 mg/kg/die; mean serum T concentration was 9.9 ± 4.2 ng/ml. Mean dose of steroids and azathioprine was 10 ± 4.4 and 65 ± 18 mg/day, respectively). C (202±48 mg/dL), TG (139±41 mg/dL), HDL (49±13 mg/dL), LDL (123±42 mg/dL), VLDL (28±7 mg/dL) were not affected by T throughout the study as well as plasma sodium and serum potassium. Drawbacks were not observed; thus no patients gave up the medication because of side effects. No liver or bone marrow alteration were found. No increase of rejection rate was observed. In conclusion T does not affect lipids in patients with KTx even after long lasting follow-up (36 months). Thus T should be preferred to other immunosuppressive agents in high-risk patients to reduce the incidence of cardiovascular events. Keywords: FK-506; transplant: outcome; transplant: complications; transplant: rejection, chronicI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
