Cyclosporine associated lesions in native kidneys of diabetic pancreas transplant recipients

Kidney Int. 1995 Aug;48(2):489-95. doi: 10.1038/ki.1995.318.


Five years of normoglycemia following pancreas transplantation (PT) does not ameliorate glomerular lesions in patients with their own kidneys and with long-term insulin-dependent diabetes (IDDM) (Lancet 342:1193, 1993). All these patients received cyclosporine (CsA) as part of their immunosuppression. Here we examined the relationship of CsA dose and blood levels to the presence and severity of CsA-associated renal lesions and changes in renal function in these PT patients. Renal biopsies were taken before (0) and two and five years after PT from 13 non-uremic IDDM patients and were compared with baseline and five year biopsies from 10 IDDM controls (C). CsA dose was reduced from 10 +/- 3 mg/kg/day in the first month to 5 +/- 2 in the fifth year post-PT. Creatinine clearance (CCr) decreased by 34% at one year post-PT and was stable thereafter, and did not change in C. The decline in CCr from 0 to one year was related to CsA blood levels and dose (P < 0.005) at one year. Cortical interstitial volume fraction [Vv(Int/Cortex)], the index of tubular atrophy, and % sclerotic glomeruli increased significantly from 0 to five years post-PT (P < 0.005, 0.01 and 0.001, respectively), but did not change in C. There was no significant change from 0 to two years post-PT in these lesions, while there was a clear progression from two to five years. Mean CsA dose and blood levels in the first year post-PT correlated with the increase (delta) in Vv(Int/Cortex) at five years (P < 0.05 for both).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Arterioles / pathology
  • Atrophy
  • Biopsy
  • Cyclosporine / adverse effects*
  • Cyclosporine / therapeutic use
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / pathology*
  • Diabetes Mellitus, Type 1 / surgery*
  • Female
  • Fibrosis
  • Humans
  • Kidney / drug effects*
  • Kidney / pathology*
  • Kidney Glomerulus / pathology
  • Male
  • Pancreas Transplantation*
  • Renal Circulation


  • Cyclosporine