Lipid parameters, doses and blood levels of calcineurin inhibitors in renal transplant patients

Ciftci H. S. , Ayna T. K. , Calıskan Y. K. , Turkmen A., Gurtekin M.

Indian Journal of Clinical Biochemistry, vol.28, no.2, pp.164-168, 2013 (Journal Indexed in ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 28 Issue: 2
  • Publication Date: 2013
  • Doi Number: 10.1007/s12291-012-0251-6
  • Title of Journal : Indian Journal of Clinical Biochemistry
  • Page Numbers: pp.164-168




The calcineurin inhibitors (CNIs) [cyclosporin

A (CsA) and tacrolimus (Tac)] are currently the most

widely prescribed drugs for maintenance of immunosuppression

after renal transplantation. These immunosuppressants

are associated with side effects such as

hyperlipidemia. We evaluated the differential effects of

different CNIs on serum lipid parameters in renal transplant

patients. Moreover, the aim of this study is to

investigate the relationships between doses and blood

levels of CNIs, and blood levels of CNIs and lipid

parameters retrospectively. Two groups of 98 non-diabetic

renal transplant patients, each treated with different CNIs,

were studied: group A (


n = 50, mean age: 31 ± 10

years), CsA, mycophenolate mofetil/azathioprin, steroid;

group B (I


= 48, mean age: 34 ± 12 years), Tac, mycophenolate

mofetil/azathioprin, steroid. In renal transplant

patients, CNIs blood levels and doses were examined at 1,

3, 6, 9, and 12 months after transplantation. Biochemical

laboratory parameters including plasma lipids [total-cholesterol

(CHOL), low-density lipoprotein (LDL)–CHOL,

high-density lipoprotein (HDL)–CHOL, and triglycerides

(TG)], CNI levels and doses were examined at 1, 3, 6, 9,

and 12 months after transplantation. None of the patients

received anti-lipidemic drugs during the study period.

Blood levels of CNIs were detectable in all whole-blood

samples by Cloned- Enzyme-Donor Immunoassay (CEDIA).

The relationship between CNIs blood levels and

CHOL, (LDL)–CHOL, HDL–CHOL, TG were evaluated.

The mean serum CHOL levels and LDL–CHOL levels of

patients in group A were found significantly higher than

the patients in group B during the 12 month of follow up



p\0.05). There was no significant difference in TG and

HDL–CHOL plasma levels between group A and group B



p[0.005). In group A the daily dose of CsA was significantly

correlated with the mean blood levels of CsA at

the 1st and 3rd months (


r = 0.387, p = 0.005; r = 0.386,



= 0.006), respectively. In group A, the daily dose of

CsA was significantly correlated with the mean serum TG

levels during the 12 month of follow up (


r = 0.420,



= 0.003). In group B, the daily dose of Tac was significantly

correlated with the mean blood level of Tac



r = 0.335, p = 0.020) at the 1st month. No correlation

was found between mean Tac blood levels and lipid

parameters during the 12-month of follow up (



Significant positive correlation was observed between the

CsA blood levels and LDL–CHOL levels (


r = 0.338,



= 0.027) at the 3rd month. In the renal transplant

patients with well functioning grafts, CsA therapy is

associated with increased CHOL and LDL–CHOL ratio

which represents an increased atherogenic risk tended to

be associated with CsA. Serum LDL–CHOL levels may

be effected by blood CsA levels.