Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (14): 2236-2240.doi: 10.3969/j.issn.2095-4344.3124

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Influence of conversion from cyclosporine to tacrolimus on glucose metabolism and cardiovascular risk profiles in stable kidney transplant patients

Wang Xiaobo, Wang Changan, Han Jianle, Yang Qingyan, Yang Shuaiping, Yang Junwei   

  1. Department of Kidney Transplantation and Nephrology, the 7th People’s Hospital of Zhengzhou, Zhengzhou 450016, Henan Province, China
  • Received:2020-03-31 Revised:2020-04-03 Accepted:2020-05-13 Online:2021-05-18 Published:2020-12-31
  • About author:Wang Xiaobo, Master, Attending physician, Department of Kidney Transplantation and Nephrology, the 7th People’s Hospital of Zhengzhou, Zhengzhou 450016, Henan Province, China

Abstract: BACKGROUND: The pros and cons of conversion from cyclosporine to tacrolimus are unclear in stable kidney transplant patients. It is generally believed that cyclosporine increases cardiovascular risks, while tacrolimus has a negative effect on glucose metabolism.
OBJECTIVE: To discuss the effects of conversion from cyclosporine to tacrolimus on glucose metabolism and cardiovascular risk in stable kidney transplant patients.
METHODS: Sixty-nine renal transplant recipients who met the inclusion criteria were randomly divided into a conversion group (n=36, cyclosporine was converted to tacrolimus) and a control group (n=33, cyclosporine was given continuously). Blood glucose, blood lipid, blood pressure, renal function, cardiovascular risk factors, body mass and combination medication were monitored at enrollment, 3 months and 6 months. The study was approved by the Ethics Committee of the 7th People’s Hospital of Zhengzhou.
RESULTS AND CONCLUSION: After 6 months of conversion, fasting blood glucose level increased from (5.6±1.0) to (6.0±1.2) mmol/L (P=0.007); the glycosylated hemoglobin level increased from (5.7±0.8)% to (6.0±1.2)% (P=0.016). Among cardiovascular risk factors, fibrinogen level decreased from (3.16±0.7) to (2.89±0.7) g/L (P=0.015); high-density lipoprotein cholesterol level decreased from (1.76±0.5) to (1.65±0.4) mmol/L (P=0.012); body mass index decreased from (24.3±3.6) to (23.7±3.4) kg/m2 (P=0.037). There were no significant changes in the other factors, including creatinine, urinary protein-creatinine ratio, blood pressure and blood lipid (P > 0.05). These findings indicate that switching immunosuppressant therapy from cyclosporine to tacrolimus significantly increases blood glucose level in stable kidney transplant patients, with no evident advantage in reducing cardiovascular risk.


Key words: kidney transplantation, tacrolimus, cyclosporine, immunosuppression, blood glucose, blood lipid, kidney function, cardiovascular risk

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