ASSOCIATION OF CYCLOSPORINE-A WITH ACQUIRED CYSTIC KIDNEY-DISEASE OF THE NATIVE KIDNEYS IN RENAL-TRANSPLANT RECIPIENTS

Acquired cystic kidney disease (ACKD) is a common complication in pati ents treated with long-term dialysis. Previous studies performed prior to the cyclosporin A (CsA) era indicate that successful renal transpl antation causes regression of ACKD. Little has been published, however , on the occurrence of ACKD in CsA-treated transplant recipients. We c onducted a prospective sonographic study in 33 renal transplant recipi ents and 32 dialysis patients to evaluate the effect of CsA on ACKD in transplant recipients. Transplant recipients had a lower prevalence ( 39% vs. 56% in dialysis patients) and severity (smaller kidneys and lo wer cyst grades) of ACKD when compared with dialysis patients. Renal c ell carcinoma was found in two dialysis patients. Using multiple regre ssion analysis, we found that the use of CsA was significantly correla ted with the presence of ACKD in transplant recipients (57% in CsA-tre ated vs. 8% in non-CsA-treated patients). We conclude that renal trans plantation reduces the prevalence and severity of ACKD in the native k idneys; however, among transplant patients, CsA administration is asso ciated with a greater prevalence of ACKD.