Results of the Minnesota Randomized Prospective Trial of Cyclosporine Versus Azathioprine-Antilymphocyte Globulin for Immunosuppression in Renal Allograft Recipients

Sutherland, David E.R.; Fryd, David S.; Strand, Marilyn H.; Canafax, Daniel M.; Ascher, Nancy L.; Payne, William D.; Simmons, Richard L.; Najarían, John S.

doi:10.1016/s0272-6386(85)80161-x

Cited by 58 publications

(14 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…From the point of view of immunosuppression, patients receiving cyclosporin A prednisone treatment presented with fewer infectious complications (including nocardiosis) than those receiving azathioprine prednisone, as the latter combination causes greater selective suppression of T lymphocytes (15,16). In their two series comparing the frequency of Nocardia infection using both immunosuppression regimens, Arduino et al (13) observed a 0.7% decrease in the incidence of nocardiosis in the last series, compared to 2.6% in the first.…”

Section: Discussionmentioning

confidence: 99%

Nocardial infection in immunosuppressed kidney transplant recipients

Queipo-Zaragozá

Broseta-Rico

Alapont-Alacreu

et al. 2004

Scandinavian Journal of Urology and Nephrology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Nocardial infection in immunosuppressed kidney transplant recipients

Queipo-Zaragozá

Broseta-Rico

Alapont-Alacreu

et al. 2004

Scandinavian Journal of Urology and Nephrology

View full text Add to dashboard Cite

show abstract

“…CsA has numerous side effects, of which nephrotoxicity [2,3] and hyperuricemia [4 ]are the most important. As many as 50% of patients taking CsA become hyperuricemic [5,6,7] and approximately 10% develop gout [8]. The hyperuricemia from CsA results from a decrease in the glomerular filtration rate [9] as well as an increase in net tubular urate reabsorption [10,11].…”

Section: Introductionmentioning

confidence: 99%

Use of Uric Acid-Lowering Agents Limits Experimental Cyclosporine Nephropathy

Mazali

Johnson²,

Mazzali³

2011

Nephron Exp Nephrol

View full text Add to dashboard Cite

Background: Hyperuricemia frequently complicates cyclosporine (CsA) therapy. Previous studies have shown that hyperuricemia exacerbates interstitial and vascular lesions in the cyclosporine model. We tested the hypothesis that normalization of uric acid could prevent the development of cyclosporine toxicity. Methods: CsA nephropathy was induced by administering CsA (15 mg/kg/day) for 7 weeks to rats on a low salt diet (CsA group). The effect of preventing hyperuricemia was determined by concomitant treatment with a xanthine oxidase inhibitor, allopurinol (CsAALP), or with a uricosuric, benzbromarone (CsABENZ), in drinking water. Control groups included vehicle-treated rats. Results: CsA-treated rats developed mild hyperuricemia with arteriolar hyalinosis, tubular atrophy, striped interstitial fibrosis, increased cell proliferation and decreased VEGF expression. Treatment with allopurinol or benzbromarone limited renal disease, with reduced interstitial fibrosis, cell proliferation, macrophage infiltration, osteopontin expression and arteriolar hyalinosis, in association with restoration of VEGF expression. Both drugs provided comparable protection. Conclusions: An increase in uric acid exacerbates CsA nephropathy in the rat. Concomitant treatment with allopurinol or benzbromarone reduced the severity of renal disease. The similar protection observed with both drugs suggests that the effect is associated more with lowering uric acid levels than the antioxidant effect of allopurinol.

show abstract

“…The frequency of CsA nephrotoxicity following kidney transplantation varies between 10 and 54% in different reports [1 , 3]. …”

Section: Introductionmentioning

confidence: 99%

Cyclosporin A Toxicity of the Renal Allograft – a Late Complication and Potentially Reversible

Sommerer

Hergesell²,

Nahm³

et al. 2002

Nephron

View full text Add to dashboard Cite

Cyclosporin A (CsA) has improved patient and organ graft survival, but the dichotomy of benefit and toxicity is still an issue. In a retrospective analysis of 392 renal transplant recipients we documented CsA nephrotoxicity (striped fibrosis, arteriolar wall hyalinosis) in 28 (7.1%) patients (23 male/5 female) in a follow-up of more than one year post transplantation. Median age at renal transplantation was 41 years (13–60) and the period between transplantation and graft biopsy was 42 months (12–122). Median CsA trough levels (ng/ml) at 12 months post transplantation, at time of graft biopsy and at last follow-up were: 114 (71–265), 130 (78–285), 66 (24–115). The following parameters were assessed at 12 months post transplantation, at time of biopsy and at last follow-up: s-creatinine (µmol/l), Doppler resistive index, systolic and diastolic blood pressure (mm Hg) and the number of antihypertensives. Median s-creatinine at 12 months post transplantation was 150.3 (94.6–247.5), at biopsy 225.4 (121.1–353.6) and at last follow-up 160.0 (106.1–247.5) (p < 0.001 for biopsy vs. last follow-up). Resistive index decreased from 0.70 (0.64–0.88) to 0.68 (0.51–0.84) (p < 0.005), systolic blood pressure from 137 (100–168) to 130 (105–144) (p < 0.05) and the number of patients with more than 4 antihypertensives from 10 to 6 between biopsy and last follow-up, with no acute rejection episodes after modification of immunosuppressive therapy (50% of previous CsA trough level and addition of azathioprine or mycophenolate mofetil). Conclusion: CsA nephrotoxicity occurs late after renal transplantation with increased systolic blood pressure and Doppler resistive index. Reduction of CsA improves renal function, reduces graft resistive index and systolic blood pressure.

show abstract

Results of the Minnesota Randomized Prospective Trial of Cyclosporine Versus Azathioprine-Antilymphocyte Globulin for Immunosuppression in Renal Allograft Recipients

Cited by 58 publications

References 11 publications

Nocardial infection in immunosuppressed kidney transplant recipients

Nocardial infection in immunosuppressed kidney transplant recipients

Use of Uric Acid-Lowering Agents Limits Experimental Cyclosporine Nephropathy

Cyclosporin A Toxicity of the Renal Allograft – a Late Complication and Potentially Reversible

Contact Info

Product

Resources

About