Zusammenfassung
Nach Nierentransplantation gehen 30–40% der transplantierten, noch funktionierenden Organe infolge Tod des Patienten verloren. Die Prävalenz der bedeutsamen kardiovaskulären Risikofaktoren Hypertonie und Hyperlipidämie beträgt bei nierentransplantierten Patienten 70–90% bzw. 30–60%. Die Folge davon ist eine 5fach gesteigerte Inzidenz kardiovaskulärer Erkrankungen nach Nierentransplantation im Vergleich zu einer altersgematchten Kontrollpopulation. Da einige Immunsuppressiva einen ungünstigen Einfluss auf die oben genannten Risikofaktoren haben, soll im Folgenden der Einfluss der einzelnen Immunsuppressiva auf die Hypertonie und die Hyperlipidämie dargelegt und Möglichkeiten der Beeinflussung dieser Risikofaktoren durch Umstellung der Immunsuppression diskutiert werden.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Literatur
Blum CB (2000) Cholesterol and triglyceride levels in sirolimus-treated rena transplant recipients. J Am Soc Nephrol 11:680A.
Harris KP, Russell Gl, Parvin SD, Veitch PS, Walls J (1986) Alterations in lipid and carbohydrate metabolism attributable to cyclosporin A in renal transplant recipients. Br Med J 292:16.
Houde I, Isenring P, Boucher D, Noel R, Lachanche JG (2000) Mycophenolate mofetil, an alternative to cyclosporine A for long-term immunosuppression in kidney transplantation? Transplantation 70:1251–1253.
Jarowenko MV, Flechner SM, Van Buren CT, Lorber MI, Kahan BD (1987) Influence of cyclosporine on posttransplant blood pressure response. Am J Kidney Dis 10:98–103.
Jensik SC (1998) Tacrolimus (FK 506) in kidney transplantation: three-year survival results of the US multicenter, randomized, comparative trial. FK 506 Kidney Transplant Study Group. Transplant Proc 30:1216–1218.
Kasiske BL, Chakkera HA, Louis TA, Ma JZ (2000) A meta-analysis of immunosuppression withdrawal trials in renal transplantation. J Am Soc Nephrol 11:1910–1917.
Kasiske BL (2000) Cardiovascular disease after renal transplantation. Semin Nephrol 20:176–187.
Mailloux LU, Levey AS (1998) Hypertension in patients with chronic renal disease. Am J Kidney Dis 32:S120–141.
Matas AJ, Burke JF Jr, DeVault GA Jr, Monaco A, Pirsch JD (1994) Chronic rejection. J Am Soc Nephrol 4:S23–29.
Mayer AD et al. (1997) Multicenter randomized trial comparing tacrolimus (FK506) and cyclosporine in the prevention of renal allograft rejection: a report of the European Tacrolimus Multicenter Renal Study Group. Transplantation 64:436–443.
McCune TR et al. (1998) Effects of tacrolimus on hyperlipidemia after successful renal transplantation: a Southeastern Organ Procurement Foundation multicenter clinical study. Transplantation 65:87–92.
Ojo AO, Hanson JA, Wolfe RA, Leichtman AB, Agodoa LY, Port FK (2000) Long-term survival in renal transplant recipients with graft function. Kidney Int 57:307–313.
Ojo AO, Meier-Kriesche HU, Hanson JA et al. (2000) Mycophenolate mofetil reduces late renal allograft loss independent of acute rejection [see comments]. Transplantation 69:2405–2409.
Opelz G, Wujciak T, Ritz E (1998) Association of chronic kidney graft failure with recipient blood pressure. Collaborative Transplant Study. Kidney Int 53:217–222.
Paul LC, Benediktsson H (1995) Post-transplant hypertension and chronic renal allograft failure. Kidney Int [Suppl 52]:S34–37.
Pirsch JD, Miller J, Deierhoi MH, Vincenti F, Filo RS (1997) A comparison of tacrolimus (FK506) and cyclosporine for immunosuppression after cadaveric renal transplantation. FK506 Kidney Transplant Study Group [see comments]. Transplantation 63:977–983.
Radermacher J, Burg M, Pethig M, Gwinner W, Schwarz A, Haller H, Kliem V (2000) Improved lipid profile in renal transplant patients switched from cyclosporine to tacrolimus treatment. DMW [Suppl3]:78.
Raine AE, Carter R, Mann JI, Morris PJ (1988) Adverse effect of cyclosporin on plasma cholesterol in renal transplant recipients. Nephrol Dial Transplant 3:458–463.
Schorn TF, Kliem V, Bojanovski M, Bojanovski D, Repp H, Bunzendahl H, Frei U (1991) Impact of long-term immunosuppression with cyclosporin A on serum lipids in stable renal transplant recipients. Transpl Int 4:92–95.
Steroid Withdrawal Group (1999) Prednisolone withdrawal in kidney transplant recipients on cyclosporin and mycopenolate mofetil-a prospective randomized study. Transplantation 68:1865–1874.
Warrens AN (2000) The evolving role of mycophenolate mofetil in renal transplantation. Qjm 93:15–20.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2001 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Burg, M., Kliem, V. (2001). Einfluss der Immunsuppression auf kardiovaskuläre Risikofaktoren nach Nierentransplantation. In: Frei, U., Klempnauer, J., Ringe, B., Sperschneider, H. (eds) Langzeitüberleben nach Nierentransplantation sichern. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59464-9_15
Download citation
DOI: https://doi.org/10.1007/978-3-642-59464-9_15
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-63986-9
Online ISBN: 978-3-642-59464-9
eBook Packages: Springer Book Archive