Int. Journal of Clinical Pharmacology and Therapeutics, Volume 44 - September (422 - 427)

Increase in renal vascular resistance after intake of cyclosporin A and tacrolimus and reversal by nitroglycerin spray: a study in patients with stable renal allograft function*
C. Weingart , T. Leingärtner, T. Bergler, B. Krüger, C. Böger, M. Mack, B. Banas, B.K. Krämer
Clinic and Policlinic for Internal Medicine II – Nephrology, University of Regensburg, Regensburg, Germany

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DOI 10.5414/CPP44422

Abstract

Purpose: Acute effects of drug administration on renal arterial resistance index (RI) are still discussed controversially. In our study we investigated the immediate effects of cyclosporin A (CyA) and tacrolimus (FK-506) on renal arterial resistance indices in patients with stable graft function after renal transplantation. Additionally we studied the effects of nitroglycerin spray on resistance indices. Methods: RI was measured by color Doppler sonography at baseline, at 1 and 2 hours after intake of medication and 30 minutes after administration of nitroglycerin spray which followed the 2-hour measurement. 34 renal transplant recipients were examined. 16 patients received CyA, 18 patients received FK-506. Whole blood levels of calcineurin inhibitors were taken at each time point. Arterial blood pressure and heart rate were measured to assess possible systemic hemodynamic effects. Results: Mean RI values increased significantly in both groups 1 hour after calcineurin inhibitor intake and remained still significantly elevated after 2 hours. There was no significant increase of mean arterial blood pressure nor was there any correlation between whole blood levels of calcineurin inhibitors and mean RI. 30 minutes after administration of nitroglycerin spray, mean RI values decreased significantly to a level even below baseline. Mean arterial blood pressure also decreased after administration of nitroglycerin. Conclusion: Renal RI values are markedly influenced by a recent intake of calcineurin inhibitors and vasoactive substances such as nitrates. This demonstrates the necessity of keeping standardized conditions when using RI as a tool in follow-up investigations after renal transplantation.

*This work was presented at the 9th NephroPharmacology meeting on October 8, 2005 in Ulm, Germany

Author Details

Authors

Departments

  • Clinic and Policlinic for Internal Medicine II – Nephrology, University of Regensburg, Regensburg, Germany

Address

C. Weingart, MD
Clinic and Policlinic for Internal Medicine II – Nephrology
University of Regensburg
Franz-Josef-Strauß-Allee 11
93053 Regensburg, Germany
Email: [email protected]

Citation

C. Weingart , T. Leingärtner, T. Bergler, B. Krüger, C. Böger, M. Mack, B. Banas and B.K. Krämer.Increase in renal vascular resistance after intake of cyclosporin A and tacrolimus and reversal by nitroglycerin spray: a study in patients with stable renal allograft function*. 2006; 44: 422-427. doi: 10.5414/CPP44422.

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