Morales J M, Andres A, Montoyo C, Ortuño B, Rodicio J L
Department of Nephrology, Hospital 12 de Octubre, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
Nephron. 1991;57(2):227-9. doi: 10.1159/000186256.
We report a case of prolonged oliguric acute renal failure after renal transplantation under steroids and ciclosporin (Cs) immunosuppression. In the 2nd week when low fractional excretion of sodium values in the presence of oliguria (as expression of Cs nephrotoxicity) and high Cs blood levels were seen, a calcium antagonist drug was administered. Also, a Cs dose adjustment was made. Then, the diuresis and fractional excretion of sodium increased together with a progressive renal function. Although this evolution could be explained as a spontaneous resolution of postischemic renal failure, we speculated that in this case of established early Cs nephrotoxicity the effect of a calcium antagonist drug, such as nifedipine, could be beneficial.
我们报告一例在使用类固醇和环孢素（Cs）免疫抑制的肾移植术后出现长时间少尿性急性肾衰竭的病例。在第2周时，出现少尿情况下低钠排泄分数值（作为Cs肾毒性的表现）以及高Cs血药浓度，此时给予了一种钙拮抗剂药物。同时，对Cs剂量进行了调整。随后，尿量和钠排泄分数增加，肾功能逐渐改善。尽管这种病情演变可解释为缺血后肾衰竭的自发缓解，但我们推测在这个已确诊早期Cs肾毒性的病例中，钙拮抗剂药物（如硝苯地平）可能起到了有益作用。
