Pedersen E B, Sørensen S S, Eiskjaer H, Skovbon H, Thomsen K
Department of Medicine and Nephrology C, Skejby Hospital, Aarhus, Denmark.
Kidney Int Suppl. 1992 May;36:S82-6.
The nephrotoxic adverse effect of cyclosporine in renal transplantation may be counteracted by calcium antagonists. The effect of a single oral dose of 10 mg of the calcium antagonist felodipine or placebo was studied in ten cyclosporine-treated renal transplant recipients before, during, and after an acute intravenous infusion of cyclosporine in a randomized, single-blind crossover study. Glomerular filtration rate, and renal plasma flow, and tubular function evaluated by the lithium clearance technique were determined. Both glomerular filtration rate, renal plasma flow, urinary sodium excretion, fractional excretion of sodium, and lithium clearance increased after felodipine, whereas proximal and distal fractional reabsorption and blood pressure were reduced. Intravenous infusion of cyclosporine per se did not influence any of the parameters. It is concluded that a single dose of felodipine in cyclosporine-treated renal transplant recipients has beneficial effects on renal hemodynamics, tubular function and blood pressure. It is suggested that these effects result from a direct vasodilatation and an effect on tubular function, and that felodipine given intravenously seems to antagonize at least some of the nephrotoxic effects of cyclosporine.
钙拮抗剂可抵消环孢素在肾移植中的肾毒性不良反应。在一项随机、单盲交叉研究中，对10名接受环孢素治疗的肾移植受者在急性静脉输注环孢素之前、期间和之后，研究了单次口服10毫克钙拮抗剂非洛地平或安慰剂的效果。测定了肾小球滤过率、肾血浆流量以及通过锂清除技术评估的肾小管功能。服用非洛地平后，肾小球滤过率、肾血浆流量、尿钠排泄、钠分数排泄和锂清除率均增加，而近端和远端分数重吸收以及血压降低。静脉输注环孢素本身并未影响任何参数。得出的结论是，在接受环孢素治疗的肾移植受者中，单次服用非洛地平对肾血流动力学、肾小管功能和血压具有有益作用。提示这些作用源于直接血管舒张和对肾小管功能的影响，并且静脉给予非洛地平似乎至少可拮抗环孢素的某些肾毒性作用。
