Why the study?
Does cyclosporine A compared to tacrolimus differentially affect oxidative stress markers (ox-LDL, AOPP, TAS) in patients after kidney transplantation?
RCT (n=53)
Open-label
Randomized
No
Does cyclosporine A compared to tacrolimus differentially affect oxidative stress markers (ox-LDL, AOPP, TAS) in patients after kidney transplantation?
Absolute Event Rate: 65.1% vs 61.4%
p-value: p=0.545
AOPP is a more sensitive marker than ox-LDL for assessing improvements in oxidative stress following kidney transplantation, regardless of whether cyclosporine A or tacrolimus is used.
Ox-LDL levels do not differentiate calcineurin inhibitors post-transplant; supports prioritizing more sensitive markers such as AOPP in future studies.
AIMS: Restoration of renal function after kidney transplantation (KT) is expected to improve oxidative stress (OS). However, little is known about the influence of calcineurin inhibitors on oxidized low-density lipoproteins (ox-LDL) after KT. The aim of this study was to evaluate ox-LDLs and related markers of OS, advanced oxidation protein products (AOPP) and total antioxidant status (TAS) in patients after KT on either cyclosporin A (CyA) or tacrolimus (Tac) treatment. METHODS: This was a prospective, randomized, single-center 12 month study evaluating time-dependent changes in biomarkers of OS before and after KT. Twenty nine patients (mean age 54.4 ± 11.1; 55% male and 45% female) were treated with CyA (Group A) and twenty four patients (mean age 52.9 ± 9.9; 75% male and 25% female) were treated with Tac (Group B). The ox-LDL, AOPP, TAS, lipid metabolism parameters, creatinine and glomerular filtration were assessed on day 1 before KT and on days 1 and 7, and in months 1, 3, 6 and 12 after KT. RESULTS: Over the 12 months, the ox-LDL for group A changed from 69.2±32.9 to 65.1±17.1 U/L (P=0.665), while AOPP significantly decreased from 233.0±159.6 to 156.5±90.1 μmol/L (P=0.025) and TAS from 1.87±0.31 to 1.68±0.20 mmol/L (P=0.030). For group B the ox-LDL changed from 62.9±29.7 to ± 61.4±14.6 U/L (P=0.168) and TAS from 1.87±0.51 to 1.68±0.20 mmol/L (P=0.168), while AOPP significantly decreased from 180.5±90.0 to 123.9±37.7 μmol/L (P=0.019). CONCLUSION: AOPP is more sensitive than ox-LDL for assessing OS after KT. TAS values appear to be insufficiently sensitive for monitoring OS in patients after KT.
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Zadražil et al. (2012) conducted an RCT in Kidney transplantation (n=53). Cyclosporine A vs. Tacrolimus was evaluated on ox-LDL at 12 months (U/L) (p=0.545).
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