Williams A W, Morgenstern B Z, Murphy M, Milliner D S
Department of Pediatrics, Mayo Clinic and Foundation, Rochester, Minnesota.
Pediatr Nephrol. 1994 Oct;8(5):566-9. doi: 10.1007/BF00858128.
There have been concerns regarding long-term adverse effects of cyclosporine A (CSA) on renal allograft function. In a retrospective study, we compared long-term allograft function up to 70 months after renal transplantation in pediatric recipients treated with and without CSA, using iothalamate clearance to assess glomerular filtration rate. Patients received CSA, prednisone, and azathioprine (CSA group, n = 16) or prednisone and azathioprine alone (Pred/AZA, n = 11). At 48 months post transplant, the iothalamate clearances (mean +/- SD) were 57.9 +/- 26.8 ml/min per 1.73 m2 in the CSA group and 68.5 +/- 20.2 in the Pred/AZA group (P > 0.05). The mean of the slopes of individual iothalamate clearances versus time during the first 70 months following transplantation were -0.156 in the CSA group and 0.095 in the Pred/AZA group. Neither slope was statistically different from zero. These data suggest that allograft function is not significantly depressed by CSA at 48 months post transplantation and that there is no greater rate of decline in allograft function up to 70 months post transplantation in patients receiving CSA when compared with the AZA/Pred group.
人们一直担心环孢素A（CSA）对肾移植功能的长期不良影响。在一项回顾性研究中，我们比较了接受和未接受CSA治疗的小儿肾移植受者在肾移植后长达70个月的长期移植肾功能，使用碘他拉酸盐清除率来评估肾小球滤过率。患者接受CSA、泼尼松和硫唑嘌呤（CSA组，n = 16）或仅接受泼尼松和硫唑嘌呤（Pred/AZA组，n = 11）。移植后48个月，CSA组碘他拉酸盐清除率（均值±标准差）为每1.73 m2 57.9±26.8 ml/min，Pred/AZA组为68.5±20.2（P>0.05）。移植后前70个月内，CSA组个体碘他拉酸盐清除率与时间的斜率均值为-0.156，Pred/AZA组为0.095。两个斜率与零均无统计学差异。这些数据表明，移植后48个月时，CSA不会显著降低移植肾功能，并且与AZA/Pred组相比，接受CSA治疗的患者在移植后长达70个月内移植肾功能的下降速率没有更大。
