Impact of Conversion From Cyclosporine to Tacrolimus on Glucose Metabolism and Cardiovascular Risk Profiles in Long-Term Stable Kidney Transplant Recipients |
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| Affiliation: | 1. Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea;2. Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea;3. Department of Clinical Pathology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea;1. Department of Surgery, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea;2. Department of Transplantation Surgery, Severance Hospital, Yonsei University Health System, Seoul, Korea;3. Department of Surgery, Korea University College of Medicine, Seoul, Korea;4. Department of Surgery, Samsung Medical Center, Seoul, Korea;5. Department of Surgery, Chonbuk University College of Medicine, Jeonju, Korea;6. Department of Internal Medicine, Kyungpook National University College of Medicine, Daegu, Korea;7. Department of Surgery, Wonkwang University College of Medicine, Iksan, Korea;8. Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea;9. Department of Surgery, Hallym University College of Medicine, Seoul, Korea;1. Department of Organ Transplant Center, Kyungpook National University Hospital, Daegu, Korea;2. Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea;3. Department of Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Korea;1. Department of Internal Medicine, Kyungpook National University School of Medicine and Clinical Research Center for End-Stage Renal Disease in Korea, Daegu, Korea;2. Department of Surgery, Kyungpook National University School of Medicine, Daegu, Korea;3. Department of Clinical Pathology, Kyungpook National University School of Medicine, Daegu, Korea;1. Department of Dermatology, Jagiellonian University, Medical College, Kraków, Poland;2. Department of Nephrology, Jagiellonian University, Medical College, Kraków, Poland;1. Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea;2. Department of Statistics, Kyungpook National University, Daegu, South Korea;3. Division of infectious disease, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea |
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| Abstract: | BackgroundCompared to tacrolimus, cyclosporine increases cardiovascular risk. Furthermore, tacrolimus has a negative effect on glucose metabolism compared to cyclosporine. This study investigated the effect of the conversion from cyclosporine to tacrolimus for immunosuppressive therapy on glucose metabolism and cardiovascular risk profiles in long-term stable kidney transplant recipients (KTRs).MethodsIn this prospective, open-label, single-arm study, 36 KTRs were enrolled; 3 were excluded. Patients were evaluated for glucose metabolism and cardiovascular risk factors at baseline, 3, and 6 months after conversion of medication. Serial changes were analyzed by repeated analysis of variance.ResultsThe mean duration from transplantation was 12.6 ± 4.0 years and baseline serum creatinine levels were 1.10 ± .23 mg/dL. After conversion, fasting plasma glucose levels increased sequentially from 101.7 ± 18.5 to 107.4 ± 21.3 mg/dL (P = .007), and glycated hemoglobin levels increased from 5.7 ± .8 to 6.0 ± 1.2% (P = .016). Among cardiovascular risk factors, fibrinogen levels were decreased (P = .015), but other factors, including blood pressure and lipid profile, did not change (all P > .05). There was no change in renal function, including serum creatinine (P = .611) and urine protein-to-creatinine ratio (P = .092). Body mass index levels were decreased (P = .037) and body weight tended to decrease (P = .063).ConclusionsSwitching immunosuppressant therapy to tacrolimus has an apparent negative effect on glucose metabolism and imparts an unclear advantage on cardiovascular risk profiles for long-term stable KTRs. |
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