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《Chongqing Medicine》 2009-17
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Slowing progression of chronic allograft nephropathy by conversion from cyclosporine to tacrolimus

LI Feng1,XIAO Ya2,WANG Ping-xian2(1.Department of Urology,Sanxia Center Hospital,Chongqing 404000,China;2.Department of Urology,Xinqiao Hospital,Third Military Medical University,Chongqing 400037,China)  
Objective To investigate the effects of substituting tacrolimus(FK506) for cyclosporine(CsA) on delaying the pace of renal dysfunction in the patients with biopsy-proven chronic allograft nephropathy(CAN) and the molecular mechanism of the therapy.Methods From January 1,2003 to May 31,2006,97 renal transplant recipients with declining graft function and biopsy-proven CAN(gradeⅠ),who had been taking cyclosporine(CsA) as immunosuppressive agent were studied.The patients were randomly divided into group A and group B.CsA was replaced with FK506 in group A including 50 patients.Group B including the other 47 patients was studied as control.Substituting CsA by FK506 in a dose of about 1:75.All patients were followed up at least three years.Renal functions,losses of creatinine clearance rates within 3 years,incidences of acute renal graft rejection and plasma TGF-β1 concentrations were compared between the two groups.Results Three year later,there were 32 patients(64.0%) with stabilized or improved graft function in group A,and 4 patients(8.5%) in group B.The difference was significant(P0.01).During the 3-year study period,loss of creatinine clearance in group A was(0.169±0.153)mL/s which was significantly more than(0.378±0.291)mL/s in group B(P0.01).At the end of the study,plasma TGF-β1 concentration in group A was(17.4±8.9) ng/mL which was significantly lower than(39.5±11.5) ng/mL in group B(P0.01).The incidences of acute rejection in both groups were not significantly different.Conclusion This study suggests that in renal recipients with biopsy-proven CAN,substituting FK506 for CsA has an effect to slow progression of CAN.Reducing production of TGF-β1 may play a decisive role in the efficacy of the therapy.
【CateGory Index】: R692
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【Citations】
Chinese Journal Full-text Database 1 Hits
1 JIANG Qing,WAQNG Ping-xian(Department of Urology,Xinqiao Hospital,Third Military Medical University,Chongqing 400037,China);Investigation for influence of TGF-β_1 on long-term renal allograft function[J];Chongqing Medicine;2008-14
【Secondary Citations】
Chinese Journal Full-text Database 2 Hits
1 WANG Ping-xian,HUANG Chi-bing,FAN Ming-qi,et al.(Department of Urology,Xinqiao Hospital,Third Military Medical University,Chongqing 400037,China);Delaying progression of chronic allograft nephropathy by conversion from cyclosporine to tacrolimus[J];Chongqing Medicine;2006-15
2 REN Yun-zhuo,HAO Jun,SI Yong-hong,et al.(Department of Pathology,Hebei Medical University,Shijiazhuang 050017,China);Effect of TGF-β_1 on human kidney tubular epithelial cells′ aptoptosis and cell proliferation dependent of the smad signaling pathway[J];Chongqing Medicine;2007-20
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