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Calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain

Patients undergoing lung transplantation (LTx) need administration of immunosuppressive therapy following the procedure to prevent graft rejection. However, these drugs are not exempt from potential risks. The development of cardiovascular risk factors and impaired renal function in the post-transpl...

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Autores principales: Nogueiras-Álvarez, Rita, Mora-Cuesta, Víctor Manuel, Cifrián-Martínez, José Manuel, de Cos-Cossío, María Ángeles, García-Sáiz, María del Mar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732215/
https://www.ncbi.nlm.nih.gov/pubmed/36481797
http://dx.doi.org/10.1038/s41598-022-25445-2
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author Nogueiras-Álvarez, Rita
Mora-Cuesta, Víctor Manuel
Cifrián-Martínez, José Manuel
de Cos-Cossío, María Ángeles
García-Sáiz, María del Mar
author_facet Nogueiras-Álvarez, Rita
Mora-Cuesta, Víctor Manuel
Cifrián-Martínez, José Manuel
de Cos-Cossío, María Ángeles
García-Sáiz, María del Mar
author_sort Nogueiras-Álvarez, Rita
collection PubMed
description Patients undergoing lung transplantation (LTx) need administration of immunosuppressive therapy following the procedure to prevent graft rejection. However, these drugs are not exempt from potential risks. The development of cardiovascular risk factors and impaired renal function in the post-transplantation period are conditions that may be favoured by the use of calcineurin inhibitor (CNI) drugs which could have repercussions on the quality of life and the post-transplantation evolution. To evaluate the cardiovascular and renal toxicity following the administration of CNI as maintenance immunosuppression in lung transplant recipients (LTRs) we reviewed a total number of 165 patients undergoing LTx between 01/01/2015 and 08/12/2018. They were divided into two groups according to the CNI drug administrated: cyclosporine (CsA-group) with 11 patients or tacrolimus (Tac-group), with 154 patients. We evaluated the de novo occurrence of arterial hypertension (HTN), diabetes mellitus (DM), hyperlipidemia and impaired renal function after initiation of CNI administration. In addition to that, the time until each of these events was assessed. A higher rate for developing HTN (p < 0.001) and impaired renal function (p = 0.047) was observed within the CsA-group. The new onset of hyperlipidemia was similar between both CNI groups and de novo appearance of DM was only documented in those LTRs receiving tacrolimus. In this LTRs retrospective study, it was observed that having ≥ 4 tacrolimus trough levels above the upper limit of the proposed interval for each specific post-LTx period was associated with an increased risk for developing renal impairment. No other statistically significant association was found between supratherapeutic CNIs blood levels and the evaluated toxicities.
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spelling pubmed-97322152022-12-10 Calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain Nogueiras-Álvarez, Rita Mora-Cuesta, Víctor Manuel Cifrián-Martínez, José Manuel de Cos-Cossío, María Ángeles García-Sáiz, María del Mar Sci Rep Article Patients undergoing lung transplantation (LTx) need administration of immunosuppressive therapy following the procedure to prevent graft rejection. However, these drugs are not exempt from potential risks. The development of cardiovascular risk factors and impaired renal function in the post-transplantation period are conditions that may be favoured by the use of calcineurin inhibitor (CNI) drugs which could have repercussions on the quality of life and the post-transplantation evolution. To evaluate the cardiovascular and renal toxicity following the administration of CNI as maintenance immunosuppression in lung transplant recipients (LTRs) we reviewed a total number of 165 patients undergoing LTx between 01/01/2015 and 08/12/2018. They were divided into two groups according to the CNI drug administrated: cyclosporine (CsA-group) with 11 patients or tacrolimus (Tac-group), with 154 patients. We evaluated the de novo occurrence of arterial hypertension (HTN), diabetes mellitus (DM), hyperlipidemia and impaired renal function after initiation of CNI administration. In addition to that, the time until each of these events was assessed. A higher rate for developing HTN (p < 0.001) and impaired renal function (p = 0.047) was observed within the CsA-group. The new onset of hyperlipidemia was similar between both CNI groups and de novo appearance of DM was only documented in those LTRs receiving tacrolimus. In this LTRs retrospective study, it was observed that having ≥ 4 tacrolimus trough levels above the upper limit of the proposed interval for each specific post-LTx period was associated with an increased risk for developing renal impairment. No other statistically significant association was found between supratherapeutic CNIs blood levels and the evaluated toxicities. Nature Publishing Group UK 2022-12-08 /pmc/articles/PMC9732215/ /pubmed/36481797 http://dx.doi.org/10.1038/s41598-022-25445-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Nogueiras-Álvarez, Rita
Mora-Cuesta, Víctor Manuel
Cifrián-Martínez, José Manuel
de Cos-Cossío, María Ángeles
García-Sáiz, María del Mar
Calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain
title Calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain
title_full Calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain
title_fullStr Calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain
title_full_unstemmed Calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain
title_short Calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the North of Spain
title_sort calcineurin inhibitors’ impact on cardiovascular and renal function, a descriptive study in lung transplant recipients from the north of spain
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9732215/
https://www.ncbi.nlm.nih.gov/pubmed/36481797
http://dx.doi.org/10.1038/s41598-022-25445-2
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