ACUTE CYCLOSPORINE-A NEPHROTOXICITY IN A RENAL-ALLOGRAFT RECIPIENT WITH HYPOTHYROIDISM

Cyclosporine A (CsA) is an important immunosuppressant in kidney trans plantation. Acute CsA nephrotoxicity secondary to high drug levels is a well-recognized complication in the immediate posttransplant period, Cyclosporine A is metabolized in the body by the hepatic cytochrome P -450 enzyme system, We present a case of a hypothyroid patient who dev eloped toxic blood CsA levels acid acute nephrotoxicity with standard doses of CsA, A reduction of CsA levels led to an improvement of allog raft function, Correction of the hypothyroid state resulted in the nor malization of CsA requirements, but overcorrection led to an increased requirement of CsA, Thyroid dysfunction should be considered as an in teracting factor in the metabolism of CsA. (C) 1995 by the National Ki dney Foundation, Inc.