Cyclosporine levels at 2 hours after dose and body mass index in relation to graft function in renal transplant patients treated with azathioprine or mycophenolate mofetil

Abstract 

The aim of this study was to evaluate the effect of C₂ levels on renal graft function in relation to body mass index (BMI). This retrospective study of 95 renal transplant patients included 53 on AZA and 42 on MMF at 3.1 years after transplantation. The cohort was divided into groups according to their C₂ levels, namely <600 ng/mL, 600 to 900 ng/mL, or >900 ng/mL, and according to BMI (>26 kg/m²). In every group, we evaluated the percentage of patients with an increase in creatinine by 1 mg/dL or ≥50% from the first year posttransplant. There was no difference in age, gender, graft source, and dose of corticosteroids or CsA between the groups. Patients on AZA with C₂ 600 to 900 ng/mL showed a lower prevalence of renal dysfunction (3.4%) than those with C₂ levels <600 ng/mL (14.3%) or >900 ng/mL (20%). Seventeen percent of the patients on AZA and 11.9% on MMF had BMI >26 kg/m² (P = NS). An increased serum creatinine was present in 22.2% of patients with BMI >26 kg/m² in the AZA group vs 20% in the cohort MMF (P = NS). These findings suggest that long-standing renal recipients on AZA with C₂ levels of between 600 and 900 ng/mL show better preservation of renal function. We did not identify differences on the basis of C₂ levels in MMF-treated recipients. The influence of BMI on long-term graft function seemed to be independent of AZA or MMF therapy.