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Renal handling of uric acid under cyclosporin A treatment

Abstract

The renal handling of uric acid during cyclosporin A (CyA) treatment was investigated by clearance studies using 24-h urine collections in 28 paediatric renal transplant recipients (CyA group), and the results were compared with those of 19 renal transplanted children treated with azathioprine and prednisolone (AZA group), 35 children with chronic renal failure (CRF) and 10 children with normal renal function (N group). Serum uric acid levels were significantly higher in the CyA group (567±156 μmol/l) compared with the AZA group (378±98), the CRF group (415±119) and the N group (290±68). Mean uric acid clearances in each group measured 3.9±2.8 ml/min per 1.73 m2 (CyA), 5.6±3.4 (AZA), 4.0±2.2 (CRF) and 8.4±3.7 (N). Calculation of the net tubular uric acid reabsorption per millilitre glomerular filtration rate revealed a significantly increased value of 0.53±0.15 μmol/ml in the CyA group (P<0.01) compared with 0.34±0.08, 0.29±0.15 and 0.27±0.07 μmol/l for the AZA, CRF and N groups respectively. We therefore conclude that CyA treatment is associated with an increased net tubular reabsorption of uric acid, which may lead to hyperuricaemia.

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References

  1. 1.

    European Multicentre Trial (1982) Cyclosporin as a sole immunosuppressive agent in recipients of kidney allografts from cadaver donors. Lancet II: 57–60

  2. 2.

    Canadian Multicenter Transplant Study Group (1983) A randomized clinical trial of cyclosporine in cadaveric renal transplantation. N Engl J Med 309: 809–815

  3. 3.

    Calne RY, Wood AJ (1985) Cyclosporin in cadaveric renal transplantation: 3-year follow-up of a European multicentre trial. Lancet II: 549

  4. 4.

    Najarian S, David S, Fryd DS, Strand M, Canafax DM, Ascher NL, Payne WD, Simmons RL, Sutherland DER (1984) A single institution, randomized, prospective trial of cyclosporine versus azathioprine-antilymphocyte globulin for immunosuppression in renal allograft recipients. Ann Surg 201: 142–157

  5. 5.

    Merion RM, White DJG, Thiru S, Evans DB, Calne RY (1984) Cyclosporin: five years experience in cadaveric renal transplantation. N Engl J Med 310: 148–154

  6. 6.

    Brodehl J, Offner G, Hoyer PF, Schirg E, Pichlmayr R, Wonigeit K (1986) Cyclosporin A in pediatric kidney transplantation and its effect on postransplantation growth. Nephron 44: 26–31

  7. 7.

    Conley SB, Flechner SM, Rose G, Van Buren CT, Brewer ED, Kahan BD (1985) Use of cyclosporine in pediatric renal transplant recipients. J Pediatr 106: 45–49

  8. 8.

    Chapman JR, Griffiths D, Harding NGL, Morris PJ (1985) Reversibility of Cyclosporin nephrotoxity after three months treatment. Lancet I: 128–129

  9. 9.

    Palestine AG, Nussenblatt RB, Chan CH (1984) Side effects of systemic cyclosporine in patients not undergoing transplantation. Am J Med 77: 652–656

  10. 10.

    Leunissen KML, Bossman F, van Hooff JP (1985) Cyclosporin, uric acid, and the kidney. Lancet I: 702

  11. 11.

    Hoyer PF, Offner G, Wonigeit K, Brodehl J, Pichlmayr R (1984) Dosage of cyclosporin A in children with renal transplants. Clin Nephrol 22: 68–71

  12. 11a

    Knoll E, Wisser H (1973) Kreatininbestimmung im Serum ohne Enteiweißung. Z Klin Chem Klin Biochem 11: 411

  13. 12.

    Donatsch P, Abisch E, Homberger M, Traber R, Trapp M, Voges R (1981) A radioimmunoassay to measure cyclosporin A in plasma and serum samples. J Immunoassay 2: 19–32

  14. 13.

    Boss GR, Seegmiller JE (1979) Hyperuricemia and gout. N Engl J Med 300: 1459–1468

  15. 14.

    Passwell JH, Modan M, Brish M, Orda S, Boichis H (1974) Fractional excretion of uric acid in infancy and childhood. Arch Dis Child 49: 878–882

  16. 15.

    Stapleton FB, Linshaw AM, Hassanein K, Gruskin AB (1978) Uric acid excretion in normal children. Pediatrics 92: 911–914

  17. 16.

    Mihatsch MJ, Thiel G, Spichtin HP, Oberholzer M, Brunner FP, Harder F, Olivieri V, Bremer R, Ryffel B, Stoecklin E, Torhorst J, Gudat F, Zollinger HU, Loertscher R (1983) Morphological findings in kidney transplants after treatment with cyclosporine. Transplant Proc 15: 2821–2835

  18. 17.

    Bergstrand A, Bohman SO, Harnsworth A (1985) Renal histopathology in kidney transplant recipients immunosuppressed with cyclosporin A: results of an international workshop. Clin Nephrol 24: 107–119

  19. 18.

    Hoyer PF, Krohn HP, Offner G, Byrd DJ, Brodehl J, Wonigeit K, Pichlmayr R (1987) Renal function after kidney transplantation in children: a comparison with conventional immunosuppression. Transplantation 43: 489–493

  20. 19.

    McKenzie N, Devineni R, Vezina W, Keown P, Stiller C (1985) The effect of cyclosporine on organ blood flow. Transplant Proc 17: 1973–1975

  21. 20.

    Cohen DJ, Loertscher R, Rubin M, Tilney NL, Carpenter CB, Strom TB (1984) Cyclosporin: renal effects and prostacyclin. Ann Intern Med 102: 420

  22. 21.

    Sullivan BA, Hak LJ, Finn FW (1985) Cyclosporine nephrotoxicity: studies in laboratory animals. Transplant Proc 4 (S1): 145–154

  23. 22.

    Pallor MS, Murray BM (1985) Renal dysfunction in animal models of cyclosporine toxicity. Transplant Proc 4 (S1): 155–159

  24. 23.

    Mace SE, Newman AJ, Liebman J (1984) Impairment of urate excretion in patients with cardiac disease. Am J Dis Child 138: 1967–1070

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Hoyer, P.F., Lee, I.J., Oemar, B.S. et al. Renal handling of uric acid under cyclosporin A treatment. Pediatr Nephrol 2, 18–21 (1988). https://doi.org/10.1007/BF00870373

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Key words

  • Cyclosporin A
  • Uric acid
  • Renal transplantation
  • Children