EFFECT OF CILASTATIN ON CYCLOSPORINE-INDUCED ACUTE NEPHROTOXICITY IN KIDNEY-TRANSPLANT RECIPIENTS

Background. Cyclosporine (CsA)-induced acute nephrotoxicity could be r educed by prevention of parenchymal accumulation of the drug itself. T he objective of this prospective study was to evaluate whether cilasta tin, an inhibitor of active tubular resorption of CsA, reduces CsA-ind uced acute nephrotoxicity in kidney graft recipients. Methods. Sixty-n ine kidney recipients with immediate graft functional recovery were ra ndomly assigned to either the treatment group (imipenem/cilastatin, n= 33) or the control group (ceftazidime, n=36). All patients followed a standard immunosuppressive regimen based on CsA and low-dose prednison e. Craft function and CsA levels were evaluated 3, 5, 10, 15, and 30 d ays after transplantation. Results. Compared with the control group, i mipenem/cilastatin administration reduced the serum creatinine level i n the first 2 weeks after transplantation, reaching a significant effe ct on postoperative day 10 (P<0.05). No significant differences were d emonstrated between the two groups for CsA levels, patient and graft s urvival, and all the other examined parameters. Conclusions. Our findi ngs support the hypothesis that cilastatin administration can reduce C sA-induced acute nephrotoxicity after kidney transplantation.