RENAL AND SYSTEMIC EFFECTS OF ATENOLOL AND TERTATOLOL IN RENAL-TRANSPLANT RECIPIENTS ON CYCLOSPORINE-A

Background. Hypertension and nephrotoxicity are well-known side-effect s of cyclosporine A (CsA). CsA-induced vasoconstriction of the afferen t glomerular arteriole probably plays a role in at least the nephrotox icity. Frequently renal transplant recipients on CsA have to be treate d with antihypertensive drugs and for this purpose also beta-blockers are used. Tertatolol is a new beta-blocker with specific vasodilatory properties, and thus might be particularly useful in CsA-treated trans plant recipients. Methods. We studied the systemic and renal haemodyna mic effects of atenolol and tertatolol in 12 hypertensive renal transp lant recipients on cyclosporine A (CsA). In a cross-over way, all pati ents were treated with atenolol and tertatolol for 4 weeks each, separ ated by a wash-out period also of 4 weeks. At the end of each period, the mean arterial pressure (MAP), heart rate, glomerular filtration ra te (GFR) and renal plasma flow (RPF) were measured. Results. The mean arterial pressure was lower (P < 0.05) during atenolol (124 +/- 2 mm H g) and tertatolol (125 +/- 2 mm Hg) treatment compared with washout (1 32 +/- 4 mm Hg). Also the heart rate was lower (P < 0.01) during ateno lol and tertatolol (54 +/- 3 and 55 +/- 2 beats/min respectively) than in the wash-out period (65 +/- 3 beats/min). GFR and RPF were not cha nged by either beta-blocker. Conclusion. Tn CsA treated renal transpla nt recipients both atenolol and tertatolol effectively reduced blood p ressure. In these patients we found no evidence of a specific vasodila tory effect of tertatolol. Both beta-blockers had no negative influenc e on renal function. Hence, these cardioprotective agents are an attra ctive and safe choice for the treatment of hypertension in such patien ts.