| Comparison of Cardiovascular Risk Profiles and Graft Function between Cyclosporin A-based and Tacrolimus-based Immunosuppression in Renal Transplant Recipients |
| Ji-Young Choi, M.D., Mi-Kyung Jin, M.D., Joo-Hyun Chun, M.D., Seung-Hyea Hyun, M.D. In-Kyong Hur, M.D., Eun-Young Lee, M.D., Ji-Hyung Cho, M.D., Sun-Hee Park, M.D. Yong-Lim Kim, M.D. and Chan-Duck Kim, M.D. |
| Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, Korea |
| 신이식 환자에서 Cyclosporine (CsA)＋Mycophenolate mofetil (MMF)＋steroid와 Tacrolimus (TAC)＋MMF＋steroid 병합요법의 심혈관계 위험성과 이식신 기능저하를 반영하는 표지자들에 대한 비교 연구 |
| 최지영 진미경 전주현 현승혜 허인경 이은영 조지형 박선희 김용림 김찬덕 |
| 경북대학교 의학전문대학원 내과학교실 |
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| Abstract |
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Purpose : Tacrolimus (TAC) may be less unfavorable than cyclosporin A (CsA) on cardiovascular morbidity and mortality in renal transplant recipients, but well controlled studies are insufficient.
Methods : In this prospective randomized controlled study, fifty seven consecutive renal transplant recipients were treated with CsA-based (CsA, MMF and steroid, CsA group: n=27) or TAC-based (TAC, MMF and steroid, TAC group: n=30) immunosuppressive regimens by randomized ratio of 1:1. In the baseline (pre-operation), 1, 3, and 6 months after transplantation, several cardiovascular risk factors and graft function were evaluated.
Results : There were no significant differences in the renal function, glucose regulation, the incidence of acute rejection and post-transplant diabetes mellitus for the post-transplant 6 months between the two groups. The blood pressure of the CsA group was maintained higher than TAC group through 6 months after transplantation even though the number of antihypertensive drugs in the CsA group was significantly higher at 3 and 6 month after transplantation. The lipid profiles except oxidized LDL were similar, but oxidized LDL level was significantly higher for the post-transplant 6 months in the CsA group (p<0.05). There were no significant differences in levels of fibrinogen, PAI-I, t-PA, hs-CRP, homocysteine, spot urine TGF-βaand βig-h3, but the uric acid level was significantly higher in the CsA group (p<0.05).
Conclusion : This study demonstrates that TAC tends to have a beneficial effect on cardiovascular risk profiles, with regard to BP and atherogenic properties of serum lipids in early post-transplant period. |
| Key Words:
Cyclosporine, Tacrolimus, Cardiovascular system, Graft survival |
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