Chulalongkorn Medical Journal


Background : Calcineurin inhibitors (CNI: cyclosporine, tacrolimus) are majorimmunosuppressants used in kidney transplant (KT) patients.Nephrotoxicity is an important side effect of CNI. The elevationof serum creatinine (Scr) is a biomarker for nephrotoxicity.However, there are several factors that affect changes of Scr.It is believed that serum cystatin C (Scys C) would be a betterbiomarker.Objective : To investigate the relationship between changes of CNI levelsand Scr and Scys C levels in KT patients.Design : Descriptive studySetting : Division of Nephrology, Department of Medicine, PhramongkutklaoHospitalPatients and Methods : Patients who received KT for at least 3 months, and duringsteady state. Blood samples were collected for determiningcyclosporine and tacrolimus trough levels, Scr and Scys C levels.Results : 217 serum samples were analysed from 56 patients (43 male,13 female). The results showed that the changes of CNI levelswere not correlated with the changes of Scr (r = -0.103,P = 0.194) and Scys C (r = -0.107, P = 0.176) levels.Conclusions : Patients who received KT for a long time until the steady state,the slightly changes of CNI levels, no influence on the changesof Scr and Scys C levels. Therefore, biomarker can be usedboth Scr and Scys C.


Faculty of Medicine, Chulalongkorn University

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