Change of cyclosporine absorption over the time after kidney transplantation

ABSTRACT

Although the immunosuppressant cyclosporine [CsA] is widely used after kidney transplantation over the long term, there is still no firm consensus on the best way to monitor of CsA blood levels. Cyclosporine [CsA] assay is critical for the management of renal transplant recipients due to inter- and intra-patient variation in CsA absorption and metabolism. Patients and In a retrospective cross sectional study, blood levels of CsA [through and 2 hours post dose] measured at least 5 times during 3 years post transplantation, in 7702 kidney transplant recipients from different transplant center of Tehran, IR Iran between 2008 and 2012. Cyclosporine absorption [CA] calculated C2/CO ratio. CA had a significant correlation with allograft function [P = 0.000, r =.0.285], this correlation was stronger than its relationship with CO and C2 blood levels [P = 0.000 and P = 0.000 as well as r = 0.033 and r = 0.090, respectively]. In univariate analysis during different times after transplantation, CO and C2 blood levels significantly decreased over three years follow up [P = 0.000], [P = 0.000]; While, CA reversely increases over the time [P = 0.000]. In linear regression model overall CA levels had correlation with lower age of recipient [P = 0.02], hypokalemia [P = 0.001], higher level of creatinine [P = 0.02] and triglyceride [P = 0.001]. The present study shows that CsA absorption changes trough the post-transplant time and appears to increases over time in long-term period after kidney transplantation