Effect of Cyclosporine on the Endocrine and Exocrine Pancreas in Kidney Transplant Recipients

Yoshimura, Norio; Nakai, I; Ohmori, Yoshihiro; Aikawa, Ichiro; Fukuda, M; Yasumura, Tadaki; Matsui, Shinji; Hamashima, T; Oka, Takahiro

doi:10.1016/s0272-6386(88)80065-9

Cited by 70 publications

(26 citation statements)

References 8 publications

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“…Two patients died 3. -------... ----t __ , (19) ,--. noncompliance 1.8 years after transplantation and died on dialysis (otT immunosuppression) 1.5 years later of uncertain causes.…”

Section: Resultsmentioning

confidence: 99%

“…It has, however, also been used in adults undergoing renal transplantation, both as a primary and as a rescue agent, in many centers around the world (7)(8)(9)(10)(11)(12)(13)(14). For the same toxicities, principally nephrotoxicity, neurotoxicity, and diabetogenicity (15)(16)(17)(18)(19)(20), it has been shown to have more immunosuppressive efficacy than cyclosporine-based therapy (8,9,21). This has been manifested by improved short-and projected long-term graft survival, and an increased ability to wean steroids completely (8,9,21,22).…”

mentioning

confidence: 99%

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Tacrolimus in Pediatric Renal Transplantation1

Shapiro¹,

Scantlebury²,

Jordan³

et al. 1996

Transplantation

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“…Two patients died 3. -------... ----t __ , (19) ,--. noncompliance 1.8 years after transplantation and died on dialysis (otT immunosuppression) 1.5 years later of uncertain causes.…”

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Tacrolimus in Pediatric Renal Transplantation1

Shapiro¹,

Scantlebury²,

Jordan³

et al. 1996

Transplantation

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“…New onset diabetes mellitus rates as high as 46% were reported before the introduction of CSA, largely related to the use of high-dose steroid immunosuppression required to prevent graft rejection (17,20). The introduction of CSA allowed the use of lower steroid doses, and NODM rates declined to between 3 and 14% (16,17,(21)(22)(23)(24).…”

Section: Introductionmentioning

confidence: 99%

New Onset Diabetes Mellitus in Patients Receiving Calcineurin Inhibitors: A Systematic Review and Meta-Analysis

Heisel¹,

Heisel²,

Balshaw³

et al. 2004

American Journal of Transplantation

448

286

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New onset diabetes mellitus (NODM) is a serious complication of transplantation. This meta-analysis evaluates the reported incidence of NODM after solid organ transplantation in patients receiving CNI treatment.Databases from January 1992 to April 2002 were searched. Fifty-six publications providing NODM incidence data were reviewed. Sixteen prospective, randomized comparative studies providing information on incidence of insulin-dependent diabetes mellitus (IDDM) were subjected to meta-analysis.New onset diabetes mellitus was reported in 13.4% of patients after solid organ transplantation, with a higher incidence in patients receiving tacrolimus than cyclosporine (16.6% vs. 9.8%). This trend was observed across renal, liver, heart and lung transplant groups. Meta-analysis of 16 studies included patients receiving either tacrolimus (n = = 1636) or cyclosporine (n = = 1407). The incidence of IDDM was significantly higher among tacrolimus-treated patients (10.4% vs. 4.5%, p < 0.00001), an effect observed in renal (9.8% vs. 2.7% p < 0.00001) and nonrenal (11.1% vs. 6.2%; p < 0.003) groups, and among patients receiving equal doses of concomitant medication in both treatment arms (12.0% vs. 3.0%; p < 0.00001).The reported incidence of NODM during the past decade was significantly higher among patients receiving tacrolimus than cyclosporine. These data provide a quantitative foundation for studies designed to reduce the rates of NODM following solid organ transplantation.

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“…A number of risk factors for developing PTDM have been identified in single-center, observational or casecontrol studies. These include age (6), race (6), ethnicity (9), family history (10,11), hepatitis C (2), obesity (1,6,12), donor source (deceased vs. living) (6,9), acute rejection (1,3,(9)(10)(11)(13)(14)(15)(16), the type of immunosuppressive agents used to prevent and treat rejection (1,3,(9)(10)(11)14,15,17) and the dose of corticosteroids (2,11,12,18).…”

Section: Introductionmentioning

confidence: 99%

Development of Diabetes Mellitus Following Kidney Transplantation: A Canadian Experience

Diekmann¹,

Gourishankar

Jhangri

et al. 2004

American Journal of Transplantation

115

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The onset of diabetes mellitus following kidney transplantation or post-transplant diabetes mellitus (PTDM) is now recognized as being an increasingly common complication that is associated with poor graft and patient survival. The incidence and clinical correlates of PTDM in a Canadian kidney transplant population has not been examined and may vary based on differences in demographics (i.e. race). Furthermore, little information exists on the association of variables such as cumulative dose of corticosteroids and trough calcineurin inhibitor levels and PTDM. We examined all recipients of a kidney transplant in our center between 1995 and 2001 and found an overall PTDM rate of 9.8%. Five clinical factors were independently associated with PTDM: older recipient age, deceased donor, hepatitis C antibody status, rejection episode and use of tacrolimus (vs. cyclosporine). Furthermore, cumulative corticosteroid dose and calcineurin inhibitor trough level were not associated with PTDM. This study demonstrates that in a Canadian kidney transplant population that there is a significant risk of PTDM following kidney transplantation, and it is therefore advisable to minimize this risk.

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Effect of Cyclosporine on the Endocrine and Exocrine Pancreas in Kidney Transplant Recipients

Cited by 70 publications

References 8 publications

Tacrolimus in Pediatric Renal Transplantation1

Tacrolimus in Pediatric Renal Transplantation1

New Onset Diabetes Mellitus in Patients Receiving Calcineurin Inhibitors: A Systematic Review and Meta-Analysis

Development of Diabetes Mellitus Following Kidney Transplantation: A Canadian Experience

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