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Volume: 6 Issue: 4 November 2008 - Supplement - 1



Allograft nephropathy remains a common and difficult problem after kidney transplantation. Several clinical trial studies performed to approach and manage this problem by changing the immunosuppressive regimen. Stabilization of renal function in patients with refractory rejection obtained after conversion from cyclosporine –based therapy to Tacrolimus/Mycophenolate mofetil regimen. we designed our study with 34 patients by changing their immunosuppressive regimen from cyclosporine to tacrolimus.Low dose of tacrolimus (0.03-0.05mg/kg/day) due to economical consideration, inability to check prograf plasma level routinely and diabetogenic effect of it started for patients who had GFR less than 50ml/min. plasma level of creatinine checked in 1st, 3rd and 6th month of conversion. We also compare pre conversion fasting blood sugar, blood pressure, hemoglobin, and lipid profile to 6th month of post conversion.Significant decrease in follow up plasma creatinines and patients' GFR obtained when comparison done between these values and base line data. Rise in systolic and diastolic blood pressure that was occurred after changing of regimen to tacrolimus, was statistically significant (p=0.001 and p= 0.000 respectively).Despite raising in fasting blood sugar in our patients , 92.54 ± 4.76 mg/dl before tacrolimus and 99.87 ± 7.00 mg/dl after starting tacrolimus, diabetogenic effect of tacrolimus was not statistically significant in this study (P value = 0.047). By conclusion, our study demonstrates that lower dose of prograf (0.03-0.05mg/kg/day)could be used for allograft nephropathy without additive need to check plasma level of tacrolimus routinely, although, renal function preserved satisfactory, diabetogenic and hypertensive side effect of tacrolimus diminished

Volume : 6
Issue : 4
Pages : 69

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Shiraz Transplant Center, Namazi Hospital Nephrology and Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran