Side effects of the calcineurin inhibitor, such as new-onset diabetes after kidney transplantation

Abstract

New-onset diabetes after transplantation (NODAT) is one of the frequent complications following kidney transplantation. Patients were randomized to receive cyclosporine A-or tacrolimus-based immunosuppression. Fasting and oral glucose tolerance tests were performed, and the patients were assigned to one of the following three groups based on the results: normal, impaired fasting glucose/impaired glucose tolerance (IFG/IGT), or NODAT. NODAT developed in 14% of patients receiving cyclosporine A-based immunosuppression and in 26% of patients taking tacrolimus (p = 0.0002). Albumin levels were similar, but uric acid level (p = 0.002) and the age of the recipient (p = 0.003) were significantly different comparing the diabetic and the normal groups. Evaluation of tissue samples revealed that acute cellular rejection (ACR) and interstitial fibrosis/tubular atrophy (IF/TA) were significantly different in the NODAT group. The pathological effect of new-onset diabetes after kidney transplantation can be detected in the morphology of the renal allograft earlier, before the development of any sign of functional impairment.

Prescription pattern and safety of immunosuppressive drugs in patients of renal transplant in IGIMS Patna - An observational study

“…Calcineurin inhibitors are associated with a number of potentially serious adverse effects, including nephrotoxicity, diabetes, hypertension, and neurotoxicity which contributes to morbidity and mortality after transplantation. [9][10][11][12][13] Cyclosporine has become less relevant in the modern era of organ transplantation. So 92% of kidney transplant recipients are now being prescribed tacrolimus as the first-line calcineurin inhibitor.…”

<b>Efeitos de imunossupressores sobre o sistema imunológico em transplantes de células germinativas em trutas arco-íris</b>

“…Contudo, o tacrolimus possui efeitos mais potentes: ele se liga a receptores de glicocorticoides ou progesterona e mimetiza efeitos de corticoides, potencializando sua ação imunossupressora e impedindo a sua degradação (THOMSON; BONHAM; ZEEVI, 1995). O uso de ciclosporina e do tacrolimus leva a efeitos colaterais como hipertensão arterial, diminuição fluxo sanguíneo nos rins e diabetes (KLEIN et al, 2002;BORDA et al, 2014).…”

>b<Development of immunosuppressive methods for gonadal grafting and xenogeneic germ cell transplantation in rainbow trout (>i<Oncorhynchus mykiss>/i<)>/b<

“…Although the immunosuppressants have revolutionized the organ transplantation technique in humans, the effects of the majority of these drugs on immune system of fish still very limited, including the respective side effects. Both cyclosporine and tacrolimus cause arterial hypertension, decrease blood flow in the kidneys, and diabetes (BORDA et al, 2014;KLEIN et al, 2002). Other severe effects include acute and chronic nephrotoxicity with significant reduction of glomerular filtration, especially in cyclosporine-treated patients (WHITING et al, 1982).…”