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Lipophilic dihydropyridines provide renal protection from cyclosporin toxicity
J L Rodicio1, J M Morales, L M Ruilope
1Department of Nephrology, 12 de Octubre Hospital, Madrid, Spain.
Aim:
To review cyclosporin nephrotoxicity and its prevention by calcium antagonists.
Method:
Review of published and unpublished studies.
Results:
Cyclosporin A nephrotoxicity is the most important side effect of this potent immunosuppressive drug. Several mechanisms have been implicated in the production of this adverse effect but elevated endothelin release is perhaps the most frequently cited cause. Calcium antagonists have demonstrated a beneficial effect in preventing cyclosporin A nephrotoxicity in renal cadaveric transplants, during both short- and long-term follow-up. Lacidipine, a lipophilic dihydropyridine calcium antagonist, prevents the reductions in the glomerular filtration rate and renal plasma flow that are often seen after cyclosporin A administration. This effect is not related to endothelin suppression.
Conclusions:
Calcium antagonists can provide renal protection in patients who undergo renal cadaveric transplantation and are treated with cyclosporin.