Impact of cyclosporin immunosuppression on serum magnesium and its fractional excretion in renal transplant recipients

To evaluate the effect of cyclosporine (CSA) on serum magnesium and its fractional excretion in renal transplant recipients. A cross sectional comparative study on 50 live related renal transplant recipients on CSA therapy with serum creatinine < 2.0 mg/dl and 30 healthy controls. Serum creatinin...

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Published in:Journal of the Pakistan Medical Association 2005-03, Vol.55 (3), p.98
Main Authors: Nawaz, Syed Haider, Zafar, Mirza Naqi, Naqvi, Syed Ali Anwar, Rizvi, Syed Adibul Hasan
Format: Article
Language:English
Subjects:
Adult
Case-Control Studies
Creatinine - blood
Creatinine - urine
Cross-Sectional Studies
Cyclosporine - adverse effects
Cyclosporine - metabolism
Cyclosporine - therapeutic use
Female
Glomerular Filtration Rate - drug effects
Humans
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - metabolism
Immunosuppressive Agents - therapeutic use
Kidney Transplantation - immunology
Magnesium - blood
Magnesium - urine
Male
Renal Circulation - drug effects
Vasoconstriction
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Summary:To evaluate the effect of cyclosporine (CSA) on serum magnesium and its fractional excretion in renal transplant recipients. A cross sectional comparative study on 50 live related renal transplant recipients on CSA therapy with serum creatinine < 2.0 mg/dl and 30 healthy controls. Serum creatinine, magnesium and its fractional excretion and CSA levels were monitored. Patients were followed at 6 months. The mean serum creatinine in patients was 1.41 +/- 0.42 mg/dl, cyclosporine 210 +/- 66 ng/ml at a dose of 4.8 +/- 1.4 mg/kg/day. The serum magnesium was 1.77 +/- 0.32 mg/dl vs 1.98 +/- 0.17 mg/dl in healthy controls (p < 0.05). Fractional excretion was 5.05 +/- 2.53% in patients vs 2.8 +/- 1.05% in controls (p < 0.05). No correlation was found between CSA levels (100-400 ng/ml) and serum magnesium (r = 0.053) or FEMg% (r = 0.215). Of the 50 recipients 27 (54%) had FEMg% in the control range. At 6 months follow up no difference in CSA levels was found between recipients with FEMg% in the normal range vs those with FEMg > 5%. However, serum creatinine increased from 1.42 +/- 0.30 mg/dl to 1.68 +/- 0.82 mg/dl (p < 0.05). CSA therapy lowers serum magnesium as compared to healthy controls and there is marked increase in FEMg% in 50% of the patients. Patients with FEMg > 5% developed renal function deterioration. FEMg percent can thus be a good follow up marker of CSA chronic toxicity in stable transplant recipients.
ISSN:0030-9982