Endothelial dysfunction in renal transplant recipients maintained on cyclosporine

Morris, Steve; McMurray, John J.V.; Rodger, R. S. C.; Farmer, Rosemary; Jardine, Alan G.

doi:10.1046/j.1523-1755.2000.00937.x

Cited by 136 publications

(74 citation statements)

References 26 publications

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“…Firstly, CsA is a proven inhibitor of NO-mediated smooth muscle relaxation essential for erection. 26 Therapeutic CsA levels could induce vascular endothelial cell dysfunction; 27 moreover, CsA was found to increase collagen in endothelial cells 28 and also induces upregulated expression of transforming growth factor b 1 that may induce fibrosis of the corpora cavernosa. 29 The overall impression of sexuality for male RTR was further defined by comparing the scores for all five IIEF domains in the group studied with those of published controls.…”

Section: Discussionmentioning

confidence: 99%

Critical evaluation of the factors influencing erectile function after renal transplantation

et al. 2004

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A total of 400 male renal transplant recipients (RTR) were investigated. Data on medical, sexual history, clinical examination and laboratory variables were collected. The severity of erectile dysfunction (ED) was assessed using the International Index of Erectile Function questionnaire. Univariate and multivariate logistic regression analyses were used to determine prognostic variables, which have independent impact on erectile function. ED was detected in 35.8% of the whole group. Current erectile function as compared to pretransplant status was improved, deteriorated or remained static in 44, 12.5 and 43.5% of the evaluated transplant recipients, respectively. After logistic regression analysis, age, hemoglobin level and presence of DM and/or peripheral neuropathy had significant and independent negative impact on erectile function. We concluded that renal transplantation has varying effects on erectile function. ED is highly prevalent among RTR and its pathogenesis is multifactorial.

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Section: Discussionmentioning

confidence: 99%

Critical evaluation of the factors influencing erectile function after renal transplantation

et al. 2004

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“…These findings are supported by Ragazzi et al 17 who 18 Also cyclosporin A induces hypertension. 19 Hypertension is a known risk factor for erectile dysfunction. Lastly, cyclosporin A was found to accumulate extracellular matrix by increasing collagen 1 in cyclosporintreated endothelial cells 20 and also induces up-regulated expression of transforming growth factor-beta 1 21 that may induce fibrosis of the corpora cavernosa.…”

Section: Discussionmentioning

confidence: 99%

Role of penile vascular insufficiency in erectile dysfunction in renal transplant recipients

et al. 2002

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The objectives of this study were to define the role and haemodynamic features of penile vascular insufficiency in impotent renal transplant recipients (RTR) as well as to establish the possible vascular risk factors for impotence in these patients. A total of 54 RTR (35 impotent and 19 potent) and 21 potent healthy subjects were included in this study. All patients were assessed clinically and by measurement of serum creatinine, serum bilirubin, cyclosporine blood levels, haemoglobin and total serum cholesterol. All subjects were subjected to intracavernous injection of 20 mg prostaglandin E 1 followed by colour Duplex sonographic examination. Our results showed that impotent RTR were significantly more likely than potent RTR to have hypertension, diabetes and hypercholesterolaemia (P < 0.05). Arterial occlusive disease was identified in 42.9% of impotent RTR. Findings suggestive of veno-occlusive dysfuntion were found in 68.6% and 26.3% of impotent and potent RTR, respectively (P ¼ 0.003). Unilateral ligation of the internal iliac artery has a negative role on haemodynamic parameters compared to unilateral end-to-side anastomosis to external iliac artery in impotent RTR (P < 0.05). Impotent RTR receiving more than one antihypertensive drug showed significant decrease in basal peak systolic velocity (PSV), dynamic PSV, erectile angle and cavernosal artery diameter compared to those receiving one drug (P < 0.05). In conclusion, penile vascular insufficiency appears to play a substantial role in the pathogenesis of impotence in transplant patients. Anastomosis of the graft to external iliac artery could preserve the potency to some degree. Antihypertensives should be reduced as much as possible to avoid their negative effects on erectile function.

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“…However, the adverse effects of cyclosporin A on penile erection could not be excluded easily and several issues warrant discussion. First, therapeutic concentrations of cyclosporin could inhibit NO synthase induction in the vascular smooth muscles, increase the sympathetic tone and increase the circulating endothelin levels [26,27]. Also cyclosporin A induces hypertension [27], a known risk factor for ED.…”

Section: Calcineurin Inhibitorsmentioning

confidence: 99%

“…First, therapeutic concentrations of cyclosporin could inhibit NO synthase induction in the vascular smooth muscles, increase the sympathetic tone and increase the circulating endothelin levels [26,27]. Also cyclosporin A induces hypertension [27], a known risk factor for ED. Last, cyclosporin A induces more extracellular matrix by increasing collagen 1 in cyclosporin-treated endothelial cells [28] and induces up-regulated expression of TGF-b 1 [29] that may induce fibrosis of the corpora cavernosa.…”

Section: Calcineurin Inhibitorsmentioning

confidence: 99%

Mechanisms of vasculogenic erectile dysfunction after kidney transplantation

Abdel‐Hamid

2004

BJU International

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Endothelial dysfunction in renal transplant recipients maintained on cyclosporine

Abstract: These data demonstrate impaired stimulated and basal NO production in CsA patients, indicating endothelial dysfunction. This may predispose patients to atherosclerosis and may be involved in the etiology of post-transplant hypertension.

Cited by 136 publications

References 26 publications

Critical evaluation of the factors influencing erectile function after renal transplantation

Critical evaluation of the factors influencing erectile function after renal transplantation

Role of penile vascular insufficiency in erectile dysfunction in renal transplant recipients

Mechanisms of vasculogenic erectile dysfunction after kidney transplantation

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