Skip to main content
Log in

Acute cardiovascular effects of intravenous cyclosporine

  • Published:
International Urology and Nephrology Aims and scope Submit manuscript

Abstract

The acute effects of intravenous (i.v.) cyclosporine A (CsA) on blood pressure and other haemodynamic parameters were examined in 8 patients with end-stage renal disease on haemodialysis (HD). The study was performed after the mid-week haemodialysis session, when the patients were on their dry body weight. Each patient received an i.v. infusion of 5 mg/kg of CsA in 120 ml of 5% dextrose in water during 2 hours. Heart rate, systolic and diastolic blood pressure (SBP, DBP) were monitored by the Holter system. An echocardiogram (M-mode 2-dimensional and Doppler sonography) was performed using an automatic device (Ultramark 6) before CsA administration, at 30, 60 and 120 minutes during CsA infusion, and at 30 minutes thereafter. SBP, DBP and calculated peripheral vascular resistance (CPVR) increased significantly in respect to basal values at 120 and 150 minutes (SBP: basal 130±21, 120 min: 136±20, 150 min: 140±18, p<0.05 and p<0.01, respectively. DBP: basal 80±9, 120 min: 86±13, 150 min: 88±13, p<0.05 and p<0.01, respectively. CPVR: basal 1000±228, 120 min: 1178±305, 150 min: 1236±270 dyne/s/cm5, p<0.01). However, systolic volume (SV) and cardiac output (CO) showed significant decreases from the basal values (SV: basal 103±29, 120 min: 85±22, 150 min: 85±17, p<0.05. CO: basal 8.2±2, 120 min: 7.3±1.1, 150 min: 7±1.2l/min, p<0.05). In conclusion, CsA infusion produces a significant elevation of blood pressure, which seems to be mediated by a direct action on peripheral vascular resistance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Cohen, D., Loertscher, R., Rubin, R., Tilney, N., Carpenter, C., Strom, T.: Cyclosporine: A new immunosuppressive agent for organ transplantation.Ann. Intern. Med., 101, 667 (1984).

    PubMed  CAS  Google Scholar 

  2. Thiel, G.: Experimental cyclosporine A nephrotoxicity. A summary of the International Workshop.Clin. Nephrol. 25, S205 (1986).

    Google Scholar 

  3. Chapman, R., Marcén, R., Arias, M., Raine, A., Dunnil, M., Morris, P.: Hypertension after renal transplantation. A comparison of cyclosporine and conventional immunosuppression.Transplantation, 43, 860 (1987).

    PubMed  CAS  Google Scholar 

  4. Curtis, J., Luke, R., Jones, P., Diethelm, A.: Hypertension in cyclosporine-treated renal transplant recipients is sodium dependent.Am. J. Med., 85, 134 (1989).

    Article  Google Scholar 

  5. Scherrer, U., Vissing, S., Morgan, B., Rollins, J., Tindall, R., Ring, S., Hanson, P., Mohanty, P., Victor, R.: Cyclosporine-induced sympathetic activation and hypertension after heart transplantation.N. Engl. J. Med., 323, 693 (1990).

    Article  PubMed  CAS  Google Scholar 

  6. Wagner, K., Albrecht, S., Neumayer, H.: Prevention of posttransplant acute tubular necrosis by the calcium antagonist diltiazem: A prospective randomized study.Am. J. Nephrol., 7, 287 (1987).

    Article  PubMed  CAS  Google Scholar 

  7. Feutren, G., Mihatsch, M., for the International Kidney Biopsy Registry of Cyclosporine in Autoimmune Diseases: Risk factors for cyclosporine-induced nephropathy in patients with autoimmune disease.N. Engl. J. Med., 326, 1645 (1992).

    Article  Google Scholar 

  8. Sahn, D., MeMaria, A., Kisslo, J., Weyman, A., for the Committee on M-Mode Standardization of the American Society of Echocardiography: Recommendations regarding quantitation in M-mode echocardiography: Results of a survey of echocardiographic measurements.Circulation, 58, 1072 (1978).

    PubMed  CAS  Google Scholar 

  9. Tresham, J., Whitworth, J., Scoggins, B., Bennet, W.: Cyclosporine-induced hypertension in sheep. The role of thromboxanes.Transplantation, 49, 144 (1990).

    Article  PubMed  CAS  Google Scholar 

  10. Weir, M., Klassen, D., Shen, S., Sullivan, D., Buddemeyer, E., Handwerger, B.: Acute effects of intravenous cyclosporine on blood pressure, in renal hemodynamics, and urine prostaglandin production of healthy humans.Transplantation, 49, 41 (1990).

    Article  PubMed  CAS  Google Scholar 

  11. Ellis, C., Fradin, M., Messana, J., Brown, M., Siegel, M., Hartley, A., Rocher, L., Wheeler, S., Hamilton, T., Parish, T., Ellis-Madu, M., Drell, E., Annesley, T., Cooper, K., Voorhees, J.: Cyclosporine for plaque-type psoriasis. Results of a multidose, double-blind trial.N. Engl. J. Med., 324, 277 (1991).

    Article  PubMed  CAS  Google Scholar 

  12. Bantle, J., Bourdeau, R., Ferris, T.: Suppression of plasma renin activity by cyclosporine.Am. J. Med., 83, 59 (1987).

    Article  PubMed  CAS  Google Scholar 

  13. Kiberd, B.: Cyclosporine-induced renal dysfunction in human renal allograft recipients.Transplantation, 48, 965 (1989).

    Article  PubMed  CAS  Google Scholar 

  14. Curtis, J., Luke, R., Dubovsky, E., Diethelm, A., Whelchel, F., Jones, P.: Cyclosporine in therapeutic doses increases renal allograft vascular resistance.Lancet, 2, 477 (1989).

    Google Scholar 

  15. Dawdson, I., Rooth, P., Fry, W., Sandoz, Z., Willms, C., Coorpender, L., Alway, C., Reish, J.: Prevention of acute cyclosporine-induced renal blood flow inhibition and improved immunosuppression with verapamil.Transplantation, 48, 575 (1989).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Navarro, J.F., Mora, C., Marcén, R. et al. Acute cardiovascular effects of intravenous cyclosporine. International Urology and Nephrology 28, 575–581 (1996). https://doi.org/10.1007/BF02550970

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02550970

Keywords

Navigation