INFLUENCE OF CYCLOSPORINE-A AND FK506 ON 24-H BLOOD-PRESSURE MONITORING IN KIDNEY-TRANSPLANT RECIPIENTS

Cyclosporine A (CsA) seems to exert direct effects on blood pressure a nd diurnal blood pressure alterations. After kidney transplant about 6 0% of the recipients are suffering from such alterations. In the prese nt study, blood pressure profiles of 15 FK506-treated kidney transplan t patients were compared to recipients with CsA immunosuppression. Bot h groups showed no statistical differences in number, kidney function, age, body weight, sex distribution and time after transplantation. Me an arterial blood pressure in FK506-treated patients at daytime was 10 5 +/- 2.5 mmHg, at night 109 +/- 3.0 mmHg. Systolic blood pressure dif ference was 2.3 mmHg, diastolic day/night blood pressure difference 0. 6 mmHg, and the difference of the heart frequency 6.8 beats/min. Cyclo sporin A-treated patients showed a mean arterial blood pressure during the day of 107 + 2.6 mmHg, at nighttime a mean arterial blood pressur e of 107 + 3.4 mmHg was measured. The diurnal blood pressure alteratio ns of systolic blood pressure were 0.9 mmHg, diastolic blood pressure difference 3.5 mmHg respectively, the heart frequency showed a differe nce of 4.4 beats/min. Both, FK506-treated patients and patients with C sA immunosuppression exhibit reduced diurnal blood pressure alteration s. Furthermore, mean arterial pressure in both, FK506 and CsA-treated patients was elevated and showed no statistical differences between th e groups. In FK506-treated patients, however, antihypertensive therapy was less intensive. Concerning arterial blood pressure and diurnal bl ood pressure alterations, FK506 offers no advantages as compared to cy closporine A. The reduced usage of antihypertensive drugs, however, ma y give evidence for lower hypertensive properties of FK506 as compared to CsA.