Journal Article

Effects of antioxidant supplementation on blood cyclosporin A and glomerular filtration rate in renal transplant recipients

Melanie L. Blackhall, Robert G. Fassett, James E. Sharman, Dominic P. Geraghty and Jeff S. Coombes

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 20, issue 9, pages 1970-1975
Published in print September 2005 | ISSN: 0931-0509
Published online July 2005 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh875
Effects of antioxidant supplementation on blood cyclosporin A and glomerular filtration rate in renal transplant recipients

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Background. Transplant recipients have elevated oxidative stress, which has prompted suggestions that supplementary antioxidants may be beneficial. However, only a small number of clinical trials have investigated antioxidant supplementation in transplant recipients, with very few data on their effects on patients’ immunosuppressive therapy.

Methods. A randomized placebo-controlled single-blind crossover trial was conducted in 10 renal transplant recipients (RTRs) taking cyclosporin A (CsA) as part of their immunosuppressive therapy. Each phase of the trial lasted 6 months, with a 6 month wash-out period in between. During one of the phases, patients consumed a tablet twice per day which delivered 400 IU/day of vitamin E, 500 mg/day of vitamin C and 6 mg/day of β-carotene.

Results. During antioxidant supplementation, there was no change in CsA dose. Antioxidant supplementation resulted in a significant decrease (P<0.05) in blood trough CsA by 24% (mean±SD, pre- 127.3±38.9, post- 97.2±30.7 µg/ml) compared with no change while taking the placebo (pre- 132.2±50.6, post- 138.6±56.0 µg/ml). The glomerular filtration rate was significantly (P<0.05) improved by 12% during antioxidant supplementation (pre- 66.9±20.7, post- 75.0±20.1 ml/min/1.72 m2), with no change during the placebo phase (pre- 66.8±11.8, post- 66.7±16.1 ml/min/1.72 m2). There were no significant differences (P>0.05) in markers of oxidative stress (malondialdehyde, susceptibility of plasma to oxidation) or plasma antioxidant enzymes.

Conclusion. In CsA-treated RTRs, antioxidant supplementation decreased blood CsA, which may affect adequacy of immunosuppression.

Keywords: antioxidants; cyclopsorin A; oxidative stress; renal function

Journal Article.  3582 words.  Illustrated.

Subjects: Nephrology

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