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Early renal graft function in recipients treated with the calcium channel blocker felodipine
G Nyberg1, U Haljamäe, H Herlitz
1Department of Nephrology, Sahlgrenska Hospital, University of Göteborg, Sweden.
Abstract:
Calcium channel blocking agents (CCB) differ in molecular structure and effects. Each must therefore be evaluated separately. Out of 139 patients who received cadaveric kidney transplants between March 1990 and December 1991 22 were treated with the CCB agent felodipine as antihypertensive therapy on admission and post transplant. The early function of their grafts was compared with that of grafts to patients not treated with any CCB agent pre or post transplant (n = 38). There were no other significant differences in patient or donor characteristics. In the felodipine treated group, 18/22 showed immediate onset of graft function vs 20/38 in the non CCB group (p = 0.02). Dialysis post transplant was required by one felodipine-treated patient vs 12 in the non CCB group. Serum creatinine on day 7 was lower in felodipine treated patients, median 155 vs 259 mumol/l. Felodipine treatment did not seem to cause any significant interaction with cyclosporin A (CyA). The frequency and severity of acute rejection did not differ between the groups.
Insights
Felodipine, a calcium channel blocker, improved early kidney transplant graft function and reduced dialysis needs. This study suggests felodipine is safe with cyclosporine A and does not increase rejection rates.
Area of Science:
- Nephrology
- Pharmacology
- Transplantation Medicine
Background:
- Calcium channel blockers (CCBs) exhibit diverse molecular structures and effects, necessitating individual evaluation.
- Antihypertensive therapy is crucial for kidney transplant recipients.
Purpose of the Study:
- To evaluate the impact of felodipine, a CCB, on early graft function and outcomes in cadaveric kidney transplant recipients.
Main Methods:
- A comparative study of 22 kidney transplant patients treated with felodipine versus 38 untreated patients.
- Graft function, need for post-transplant dialysis, and serum creatinine levels were assessed.
- Interaction with cyclosporine A and acute rejection rates were monitored.
Main Results:
- Felodipine treatment was associated with a significantly higher rate of immediate graft function (18/22 vs. 20/38, p = 0.02).
- Fewer felodipine-treated patients required post-transplant dialysis (1 vs. 12).
- Lower day 7 serum creatinine levels were observed in the felodipine group (median 155 vs. 259 mumol/l).
Conclusions:
- Felodipine appears to enhance early kidney allograft function and reduce the need for dialysis post-transplant.
- No significant adverse interactions between felodipine and cyclosporine A were observed.
- Felodipine treatment did not alter the incidence or severity of acute rejection in kidney transplant recipients.