Saburi Masuho, Kohashi Sumiko, Kato Jun, Koda Yuya, Sakurai Masatoshi, Toyama Takaaki, Kikuchi Taku, Karigane Daiki, Yuda Sayako, Yamane Yusuke, Hashida Risa, Abe Ryohei, Nakazato Tomonori, Hirahashi Junichi, Ogata Masao, Okamoto Shinichiro, Mori Takehiko
Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Department of Medical Oncology and Hematology, Oita University Faculty of Medicine, Oita, Japan.
Int J Hematol. 2017 Sep;106(3):431-435. doi: 10.1007/s12185-017-2253-x. Epub 2017 May 17.
Calcineurin inhibitors (CIs) such as cyclosporine A (CSA) and tacrolimus often cause renal dysfunction, resulting in increased serum creatinine, hyperkalemia, and hyperuricemia. However, the effects of CIs on sodium excretion have not been fully elucidated. We retrospectively evaluated the effects of CI administration on sodium excretion in recipients of allogeneic hematopoietic stem cell transplantation (HSCT). Fifty consecutive recipients each of allogeneic HSCT receiving either CSA or tacrolimus (100 patients in total) with available data for weekly fractional excretion of sodium (FENa) for a 4-week period after transplantation were enrolled in this retrospective analysis. No significant differences in patient characteristics were observed between CSA and tacrolimus groups except for the type of donor. FENa was significantly higher at the 3rd (1.25 ± 0.80) and 4th weeks (1.53 ± 1.06) after transplantation as compared with that at the 1st week (0.93 ± 0.51; P < 0.01, P < 0.001, respectively) in the tacrolimus group, but not at any time point in the CSA group. In addition, FENa was significantly higher in the tacrolimus group than the CSA group at the 4th week (1.53 ± 1.06 vs. 1.13 ± 0.80; P < 0.05). These results suggest that tacrolimus increases sodium excretion after allogeneic HSCT, and that this effect is minimal with CSA.
钙调神经磷酸酶抑制剂（CIs），如环孢素A（CSA）和他克莫司，常导致肾功能障碍，引起血清肌酐升高、高钾血症和高尿酸血症。然而，CIs对钠排泄的影响尚未完全阐明。我们回顾性评估了CI给药对异基因造血干细胞移植（HSCT）受者钠排泄的影响。本回顾性分析纳入了50例连续接受CSA或他克莫司的异基因HSCT受者（共100例患者），这些患者在移植后4周内有每周尿钠排泄分数（FENa）的可用数据。除供体类型外，CSA组和他克莫司组在患者特征方面未观察到显著差异。与他克莫司组移植后第1周（0.93±0.51）相比，第3周（1.25±0.80）和第4周（1.53±1.06）的FENa显著升高（分别为P<0.01，P<0.001），而CSA组在任何时间点均未出现这种情况。此外，他克莫司组在第4周的FENa显著高于CSA组（1.53±1.06 vs. 1.13±0.80；P<0.05）。这些结果表明，他克莫司会增加异基因HSCT后的钠排泄，而CSA的这种作用最小。
