Vasculopathy in cyclosporine-treated renal allografts: possible protection by diltiazem

Morphometric quantitative analysis of the renal arterioles (arteriole wall thickness and overall vessel size) in renal biopsies from 21 cadaveric renal allograft recipients taken immediately prior to (0 months) and 3 months after transplantation was carried out using a computer-aided image analyzer. Patients (n = 10) who received standard therapy (cyclosporine, azathioprine and prednisolone) showed an increase in arteriole wall thickness at 3 months compared to 0 months (p < 0.01). Patients (n = 11) who received standard therapy and oral diltiazem (60 mg t.d.s.) showed no such change in the arteriole wall thickness between 0 and 3 months. As cyclosporine toxicity and/or chronic vascular rejection are associated with an increase in arteriole wall thickness, the differences observed in this study may imply a protective role for diltiazem on renal arterioles.