Altered flow properties of blood and increased plasma fibrinogen in cyclosporin-treated renal allograft recipients

Background. Abnormalities in blood rheology may be factors contributing to cardiovascular complications and the progression of renal failure in kidney allograft recipients. The haemorheological variables haematocrit, fibrinog en, whole blood viscosity, plasma viscosity, erythrocyte aggregation tenden cy and fluidity were measured in 27 cyclosporin A (CyA)-treated patients wh o had received a renal graft at least 6 months previously. Their creatinine clearance was in the range of 12-92 ml/min/1.73 m(2) (mean 55+/-19). The v alues were compared with those obtained from a control group comprising 20 healthy subjects matched according to age, sex and smoking habits. Results. The haematocrit, plasma fibrinogen, whole blood viscosity, plasma viscosity, erythrocyte aggregation tendency, body mass index (BMI), mean ar terial pressure (MAP) and serum triglycerides were increased in the transpl anted patients, and the serum high density lipoprotein (HDL)-cholesterol an d erythrocyte fluidity decreased. The haemorheological variables were used as dependent variables in a stepwise regression analysis with age, MAP, BMI , urinary albumin excretion rate, blood CyA concentration, creatinine clear ance, and serum triglycerides, cholesterol and HDL-cholesterol as independe nt variables. Plasma fibrinogen was positively correlated with BMI and bloo d CyA. The whole blood viscosity was positively correlated with blood CyA a nd negatively with serum HDL-cholesterol. Only serum triglycerides remained correlated with erythrocyte aggregation tendency. Conclusions. All variables with a known impact on blood viscosity were alte red in the present group of renal transplant recipients. Inappropriate regu lation of erythrocyte formation, overweight, the use of CyA, high triglycer ides and low HDL-cholesterol levels may be factors contributing to this. Th e importance of impaired flow properties of blood for the development of ca rdiovascular diseases and transplant glomerulosclerosis needs to be examine d.