Background: Diltiazem and cyclosporin A (CsA) share a similar metabolism and degradation via the hepatic cytochrome p 450 subfamily 3A4. Co-administration of diltiazem with CsA may lead to CsA dosage reduction, blood pressure control and renal protection.
Objectives: To study the four year outcome of kidney transplant recipients who received diltiazem administration with CsA. This was compared to the outcomes of patients who received CsA without diltiazem and were matched for blood pressure control and other baseline characteristics.
Material And Method: Forty eight patients were included in the diltiazem group and seventy patients in the non-diltiazem group. CsA monitoring was done by using trough level (monoclonal fluorescent polarization immunoassay).
Results: The results showed that both groups has similar 4-year graft survival (92 and 95 %) with a similar mean final serum creatinine (1.3 mg/dl). Mean dose of CsA during the first month was 30 % lower in the diltiazem than non-diltiazem group. At one year CsA dose was 11% lower in the diltiazem than non-diltiazem group. However the diltiazem group was associated with significantly higher probability to have chronic allograft nephropathy than the non-diltiazem group (31% VS 19%) (RR 2.93; p = 0.03; Multivariate Cox regression).
Conclusion: Co administration of diltiazem with trough level adjusted CsA is associated with benefits in terms of CsA dose reduction and good graft survival and function. However there appeared to be no protective effect of diltiazem on the progression to chronic allograft nephropathy.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Combination therapy with diltiazem plus CsA/MMF/Pred or CsA/Aza/Pred triple immunosuppressive regimens for use in clinical kidney transplantation in Northwestern China.
Eur J Clin Pharmacol
June 2011
Department of Hepatobiliary Surgery, Third Affiliated Hospital (Shanxi Provincial People's Hospital), Medical School of Xi'an Jiaotong University, Xi'an, Shanxi Province, China,
Objective: The effects of diltiazem on 1692 kidney transplant recipients under the immunosuppressive regimen of cyclosporine A (CsA) in combination with either mycophenolate mofetil or azothioprine were assessed. The two treatment groups were compared for blood concentrations of CsA, the extent of acceptable dosage reduction for the maintenance of immunotherapy, potential effects of kidney protection, and promotion of graft function.
Method: We monitored changes of blood concentrations of CsA in the two different patient treatment groups for post-transplant graft function, episodes of acute rejection, and hepatic and renal toxicity in 1640 renal transplant recipients after treatment with diltiazem.
Co-administration of diltiazem and cyclosporine for kidney transplant recipients: a four year follow-up study.
J Med Assoc Thai
August 2006
Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Background: Diltiazem and cyclosporin A (CsA) share a similar metabolism and degradation via the hepatic cytochrome p 450 subfamily 3A4. Co-administration of diltiazem with CsA may lead to CsA dosage reduction, blood pressure control and renal protection.
Objectives: To study the four year outcome of kidney transplant recipients who received diltiazem administration with CsA.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!