Abstract:

BACKGROUND: In recent years, several studies have shown that immunosuppressive regimen of tacrolimus conversed from cyclosporine A (CsA) has a certain effect on chronic allograft nephropathy. 
OBJECTIVE: To investigate the clinical efficacy and safety of conversion from CsA to tacrolimus combined with Tripterygium wilfordii Hook. f. (TII) on CAN.
METHODS: Retrospectively analysis of 57 patients with chronic allograft nephropathy diagnosed by clinical and pathological identification. The patients were treated with CsA+mycophenolate mofetil+prednisone immunosuppressive therapy before diagnosis, and then the patients were divided into two groups according to different treatment options: CsA group (n=27) which was continued to use the initial therapy, CsA+TII group (n=30) was treated by tacrolimus instead of CsA combined with TII.
RESULTS AND CONCLUSION: There was significant difference on the level of serum creatinine and quantity of 24-hour urine protein excretion in two groups at 3 and 6 months after conversion (P < 0.05), but there were no statistical difference of those in each group at 3 and 6 months (P > 0.05). And there were no significant differences on the level of total cholesterol, triacylglycerol, alanine aminotransferase and aspartic acid aminotransferase between two groups (P > 0.05). The tremor incidence in CsA+TII group was obviously higher than that in the CsA group (P < 0.05), but the incidence of hypertension, hypertrichosis, hyperglycemia and gingival overgrowth in CsA+TII group was significantly lower than that in the CsA group (P < 0.05). Conversion from CsA to tacrolimus combined with TII has a good efficacy for the treatment of chronic allograft nephropathy in kidney transplant recipients with fewer adverse effects, which benefits for the long-term survival of allograft.