Disturbance in Renal Haemodynamics and Physiology in Bone Marrow Transplant Recipients Treated with Ciclosporin A

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Abstract

The vascular disturbance associated with ciclosporin (CS) nephrotoxicity is poorly defined in both the normal and transplanted human kidney. Six bone marrow transplant recipients were studied before, during and after administration of CS. By analysis of time activity curves and clearance of Tc-99m DTP A, renal blood flow (RBF), filtration fraction (FF) and GFR were shown to fall on CS (GFR: p < 0.001; RBF, FF: p < 0.01). These haemodynamic variables did not fully recover with dose reduction or after discontinuation of therapy. Plasma renin activity (PRA) aldosterone and atrial natriuretic peptide did not change although there appeared a tendency for PRA to fall on CS. There was a reversible normokalemic metabolic acidosis. CS levels stayed within the therapeutic range. The partial reversibility of GFR, RBF and FF is consistent with CS-induced functional disturbance and reflects sensitivity to microvascular and tubular injury of the normal human kidney.

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Author and article information

Journal

Journal ID (publisher-id): NEF

Journal ID (nlm-ta): Nephron

Journal ID (doi): 10.1159/issn.1660-8151

Title: Nephron

Publisher: S. Karger AG

ISSN (Print): 1660-8151

ISSN (Electronic): 2235-3186

Publication date Subscription-year: 1992

Publication date (Print): 1992

Publication date (Electronic): 11 December 2008

Volume: 60

Issue: 1

Pages: 17-24

Affiliations

^aDepartment of Medicine, Manchester Royal Infirmary, Manchester; ^bDepartments of Haematology and Nuclear Medicine, Hammersmith Hospital, London, UK

Article

Publisher ID: 186699 Other ID: Nephron 1992;60:17–24

DOI: 10.1159/000186699

PubMed ID: 1531379

SO-VID: d46247e1-9f4a-4127-8e36-c8072422afb4

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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

History

Date accepted : 15 April 1991

Page count

Pages: 8

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