Long term cyclosporine kinetiks and its influence on lipid status in renal transplant recipients

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LONG TERM CYCLOSPORINE KINETIKS AND ITS INFLUENCE ON LIPID STATUS IN RENAL TRANSPLANT RECIPIENTS. F. K. Matzkies, W. Keuthage, U. Gerhardt, B. Suwelack, and H. Hohage. University of Muenster, Medical Department, Mnenster, Germany We retrospectively investigated the influence of cyclosporine A treatment on cholesterol levels in 261 patients with stable renal function over a time period of 60 months. Patients were eligible if fasting serum-chnlesterul values and baseline CYA levels were available at 1, 3, 9, 12, 24, 36, 48, 60 months after transplantation. Correlation and regression analysis was perfomed on creatinine (SCr), total cholesterol, total CYA dosage (CYA d), CYA baseline values (CYA b) relation of CYA dosage and bodyweight (CYA d/w) and relation of CYA dosage to CYA baseline values (CYA d/b). Mean age was 42--12 years, mean body weight showed an increase from 64± 11 kg after transplantation to 69± 12 kg after nine months remaining stable at 60 months. CYA d was 323:~105 mg at first month with a linear reduction over time to 247±87 mg at 60 mouth (23%). CYA b showed a comparable reduction from 290~252 to 121,~63 ng/ml, respectively. CYA d/w reduced from 5,1±1.6 to 3.5±1.3 mg/kg/d over the time period of 60 months. The correlation of CYA d/b showed a slight increase from baseline 52±39 to 61±48 (9 months) and a continous decrease to 35±25 g/1. SCr was 2.0±2.5 mg/dl at baseline and fell to 1.7±1.5 mg/dl at three month with a contiuons increase to 2,0:~ 1.4 mg/dl after 60 months. Cholesterol values were 254±50 mg/dl at baseline with a slight linear increase over the time to 276±59 rag/d1 at 60 months. There was no significant correlation between CYA d, CYA h, CYA d/b, CYA d/w and cholesterol. Stratification of patients according to age, sex, time from transplantation and cholesterol value did not identify subgroups of patients with correlation to CYA values. Multiple regression analysis showed no correlation between cholesterol values and creatinine or CYA values. According to these findings We conclude: The influence of CYA on cholesterol levels is not dose dependent. Even so CYA b values were reduced by half over the entire time period, a slight increase in cholesterol values occurred. Therefore, mechanisms independent from CYA may contribute to cholesterol values. 55