Comparison of short and long-term renal function in liver transplant patients receiving cyclosporin or FK 506

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Abstract
Long‐term renal function was compared in 49 liver recipients [25 patients received cyclosporin (CyA) and 24 patients received FK 5061 followed for a period of 1 year. Creatinine (CR) and glome‐rular filtration rate (GFR) pre‐transplantation (pre‐Tx) and at 1, 3, 5, and 12 months post‐Tx were recorded, as well as incidences of hyperkalemia, post‐Tx hypertension, and insulin‐dependent diabetes mellitus (IDDM) in the two groups. At 1 year post‐Tx, the mean Cr had risen from baseline by 56% and 60% in the FK and CyA groups, respectively; the mean GFR had dropped by 32% in FK patients and by 27 % in CyA patients. Acute nephrotoxicity occurred in 1/25 CyA patients (217 required dialysis) and 9/26 FK patients (7/9 required dialysis; 211 were switched to CyA). None remained on dialysis at 3 months. Renal insufficiency persisted at 1 year in 7/16 patients with early toxicity (CyA, 4; FK, 3) and in 3 of the remaining 36 pts (P < 0.001). Hyperkalemia occurred in 4/25 CyA, and in 12/24 FK patients (P < 0.025), post‐Tx hypertension occurred in 15 CyA, and 7 FK patients (P < 0.05), and IDDM occurred in 4 CyA and 7 FK patients (P= ns). FK 506 and CyA, thus, exerted similar chronic renal effects. Although acute renal insufficiency improved upon dose reduction, renal impairment was permanent in some cases.

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