Early detection of heart transplant patients with increased risk of ciclosporin nephrotoxicity

Chronic nephrotoxic effects from ciclosporin are a common clinical complica tion after heart transplantation and frequently lead to progressive renal f ailure. There is no laboratory test to predict development of chronic renal failure in heart transplant patients. We analysed urinary retinol-binding protein (uRBP) concentration, to assess proximal tubular dysfunction, In 36 clinically stable heart transplant patients. We detected a subgroup of 13 patients who had high concentrations of uRBP, good renal function, and a hi gh risk of developing progressive renal failure compared with patients with normal uRBP (relative risk 3.87, p=0.003).