Interaction of cyclosporine and FK506 with diuretics in transplant patients
Interaction of cyclosporine and FK506 with diuretics in transplant patients. The calcineurin inhibitors cyclosporine and FK506 are widely used for immunosuppression in solid organ transplantation. One of the side effects of these agents is renal magnesium wasting. The site of action and molecular me...
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| Veröffentlicht in: | Kidney international 2000-07, Vol.58 (1), p.325-330 |
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| creator | Arthur, John M. Shamim, Shazia |
| description | Interaction of cyclosporine and FK506 with diuretics in transplant patients.
The calcineurin inhibitors cyclosporine and FK506 are widely used for immunosuppression in solid organ transplantation. One of the side effects of these agents is renal magnesium wasting. The site of action and molecular mechanism of this effect are not known. We hypothesized that agents such as diuretics that cause renal magnesium wasting through a similar action would not have an additive effect on magnesium deficiency with calcineurin inhibitors.
The records of 50 heart transplant patients on calcineurin inhibitors were reviewed to determine levels of serum magnesium and required replacement dose of magnesium, diuretic usage, and other laboratory values.
Loop diuretics did not change either the magnesium level or magnesium replacement requirements in patients on calcineurin inhibitors. In contrast, the thiazide diuretic resulted in an increase in serum magnesium and a decrease in magnesium replacement. Results were similar when the cyclosporine or FK506 groups were evaluated alone. Patients taking FK506 had lower serum magnesium values and higher requirements for magnesium replacement compared with patients taking cyclosporine.
We conclude that calcineurin inhibitors and loop diuretics have a similar site of action. |
| doi_str_mv | 10.1046/j.1523-1755.2000.00169.x |
| format | Article |
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The calcineurin inhibitors cyclosporine and FK506 are widely used for immunosuppression in solid organ transplantation. One of the side effects of these agents is renal magnesium wasting. The site of action and molecular mechanism of this effect are not known. We hypothesized that agents such as diuretics that cause renal magnesium wasting through a similar action would not have an additive effect on magnesium deficiency with calcineurin inhibitors.
The records of 50 heart transplant patients on calcineurin inhibitors were reviewed to determine levels of serum magnesium and required replacement dose of magnesium, diuretic usage, and other laboratory values.
Loop diuretics did not change either the magnesium level or magnesium replacement requirements in patients on calcineurin inhibitors. In contrast, the thiazide diuretic resulted in an increase in serum magnesium and a decrease in magnesium replacement. Results were similar when the cyclosporine or FK506 groups were evaluated alone. Patients taking FK506 had lower serum magnesium values and higher requirements for magnesium replacement compared with patients taking cyclosporine.
We conclude that calcineurin inhibitors and loop diuretics have a similar site of action.</description><identifier>ISSN: 0085-2538</identifier><identifier>EISSN: 1523-1755</identifier><identifier>DOI: 10.1046/j.1523-1755.2000.00169.x</identifier><identifier>PMID: 10886578</identifier><identifier>CODEN: KDYIA5</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Analysis of Variance ; Benzothiadiazines ; Biological and medical sciences ; calcineurin inhibition ; Calcineurin Inhibitors ; Cyclosporine - therapeutic use ; Diuretics ; Drug Interactions ; Female ; heart transplant ; Heart Transplantation ; Humans ; Immunomodulators ; immunosuppression ; Immunosuppressive Agents - therapeutic use ; loop diuretics ; Loop of Henle - drug effects ; Loop of Henle - metabolism ; Magnesium - blood ; Magnesium - therapeutic use ; magnesium deficiency ; Male ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Potassium - blood ; Retrospective Studies ; Sodium Chloride Symporter Inhibitors - therapeutic use ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Tacrolimus - therapeutic use ; thiazide diuretic</subject><ispartof>Kidney international, 2000-07, Vol.58 (1), p.325-330</ispartof><rights>2000 International Society of Nephrology</rights><rights>2000 INIST-CNRS</rights><rights>Copyright Nature Publishing Group Jul 2000</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-c9e10c0a39f8a966dd12b55e1ef992eb33b4b3996109924a4798578fb8dfe903</citedby><cites>FETCH-LOGICAL-c476t-c9e10c0a39f8a966dd12b55e1ef992eb33b4b3996109924a4798578fb8dfe903</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/210105747?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,64361,64365,72215</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1431974$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10886578$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arthur, John M.</creatorcontrib><creatorcontrib>Shamim, Shazia</creatorcontrib><title>Interaction of cyclosporine and FK506 with diuretics in transplant patients</title><title>Kidney international</title><addtitle>Kidney Int</addtitle><description>Interaction of cyclosporine and FK506 with diuretics in transplant patients.
The calcineurin inhibitors cyclosporine and FK506 are widely used for immunosuppression in solid organ transplantation. One of the side effects of these agents is renal magnesium wasting. The site of action and molecular mechanism of this effect are not known. We hypothesized that agents such as diuretics that cause renal magnesium wasting through a similar action would not have an additive effect on magnesium deficiency with calcineurin inhibitors.
The records of 50 heart transplant patients on calcineurin inhibitors were reviewed to determine levels of serum magnesium and required replacement dose of magnesium, diuretic usage, and other laboratory values.
Loop diuretics did not change either the magnesium level or magnesium replacement requirements in patients on calcineurin inhibitors. In contrast, the thiazide diuretic resulted in an increase in serum magnesium and a decrease in magnesium replacement. Results were similar when the cyclosporine or FK506 groups were evaluated alone. Patients taking FK506 had lower serum magnesium values and higher requirements for magnesium replacement compared with patients taking cyclosporine.
We conclude that calcineurin inhibitors and loop diuretics have a similar site of action.</description><subject>Analysis of Variance</subject><subject>Benzothiadiazines</subject><subject>Biological and medical sciences</subject><subject>calcineurin inhibition</subject><subject>Calcineurin Inhibitors</subject><subject>Cyclosporine - therapeutic use</subject><subject>Diuretics</subject><subject>Drug Interactions</subject><subject>Female</subject><subject>heart transplant</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>Immunomodulators</subject><subject>immunosuppression</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>loop diuretics</subject><subject>Loop of Henle - drug effects</subject><subject>Loop of Henle - metabolism</subject><subject>Magnesium - blood</subject><subject>Magnesium - therapeutic use</subject><subject>magnesium deficiency</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. Drug treatments</subject><subject>Potassium - blood</subject><subject>Retrospective Studies</subject><subject>Sodium Chloride Symporter Inhibitors - therapeutic use</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Tacrolimus - therapeutic use</subject><subject>thiazide diuretic</subject><issn>0085-2538</issn><issn>1523-1755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkE1LxDAQhoMoun78BQnitXXSNG1yVPELBS_eQ5pOMcua1iTrx7836y7qzdMwzDMzLw8hlEHJoG7O5iUTFS9YK0RZAUAJwBpVfmyR2c9gm8wApCgqweUe2Y9xnkGpOOySPQZSNqKVM3J_5xMGY5MbPR0Haj_tYozTGJxHanxPr-8FNPTdpWfau2XA5GykztMUjI_TwvhEJ5Mc-hQPyc5gFhGPNvWAPF1fPV3eFg-PN3eX5w-FrdsmFVYhAwuGq0Ea1TR9z6pOCGQ4KFVhx3lXd1yphkHua1O3SuasQyf7ARXwA3KyPjuF8XWJMen5uAw-f9QVAwairdsMyTVkwxhjwEFPwb2Y8KkZ6JVDPdcrVXqlSq8c6m-H-iOvHm_uL7sX7P8srqVl4HQDmGjNYsgmrIu_XM2ZauuMXawxzC7eHAYdbfZksXcBbdL96P4P8wUM7Y7H</recordid><startdate>20000701</startdate><enddate>20000701</enddate><creator>Arthur, John M.</creator><creator>Shamim, Shazia</creator><general>Elsevier Inc</general><general>Nature Publishing</general><general>Elsevier Limited</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20000701</creationdate><title>Interaction of cyclosporine and FK506 with diuretics in transplant patients</title><author>Arthur, John M. ; Shamim, Shazia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-c9e10c0a39f8a966dd12b55e1ef992eb33b4b3996109924a4798578fb8dfe903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Analysis of Variance</topic><topic>Benzothiadiazines</topic><topic>Biological and medical sciences</topic><topic>calcineurin inhibition</topic><topic>Calcineurin Inhibitors</topic><topic>Cyclosporine - therapeutic use</topic><topic>Diuretics</topic><topic>Drug Interactions</topic><topic>Female</topic><topic>heart transplant</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>Immunomodulators</topic><topic>immunosuppression</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>loop diuretics</topic><topic>Loop of Henle - drug effects</topic><topic>Loop of Henle - metabolism</topic><topic>Magnesium - blood</topic><topic>Magnesium - therapeutic use</topic><topic>magnesium deficiency</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Potassium - blood</topic><topic>Retrospective Studies</topic><topic>Sodium Chloride Symporter Inhibitors - therapeutic use</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Tacrolimus - therapeutic use</topic><topic>thiazide diuretic</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arthur, John M.</creatorcontrib><creatorcontrib>Shamim, Shazia</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Kidney international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arthur, John M.</au><au>Shamim, Shazia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Interaction of cyclosporine and FK506 with diuretics in transplant patients</atitle><jtitle>Kidney international</jtitle><addtitle>Kidney Int</addtitle><date>2000-07-01</date><risdate>2000</risdate><volume>58</volume><issue>1</issue><spage>325</spage><epage>330</epage><pages>325-330</pages><issn>0085-2538</issn><eissn>1523-1755</eissn><coden>KDYIA5</coden><abstract>Interaction of cyclosporine and FK506 with diuretics in transplant patients.
The calcineurin inhibitors cyclosporine and FK506 are widely used for immunosuppression in solid organ transplantation. One of the side effects of these agents is renal magnesium wasting. The site of action and molecular mechanism of this effect are not known. We hypothesized that agents such as diuretics that cause renal magnesium wasting through a similar action would not have an additive effect on magnesium deficiency with calcineurin inhibitors.
The records of 50 heart transplant patients on calcineurin inhibitors were reviewed to determine levels of serum magnesium and required replacement dose of magnesium, diuretic usage, and other laboratory values.
Loop diuretics did not change either the magnesium level or magnesium replacement requirements in patients on calcineurin inhibitors. In contrast, the thiazide diuretic resulted in an increase in serum magnesium and a decrease in magnesium replacement. Results were similar when the cyclosporine or FK506 groups were evaluated alone. Patients taking FK506 had lower serum magnesium values and higher requirements for magnesium replacement compared with patients taking cyclosporine.
We conclude that calcineurin inhibitors and loop diuretics have a similar site of action.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10886578</pmid><doi>10.1046/j.1523-1755.2000.00169.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis of Variance Benzothiadiazines Biological and medical sciences calcineurin inhibition Calcineurin Inhibitors Cyclosporine - therapeutic use Diuretics Drug Interactions Female heart transplant Heart Transplantation Humans Immunomodulators immunosuppression Immunosuppressive Agents - therapeutic use loop diuretics Loop of Henle - drug effects Loop of Henle - metabolism Magnesium - blood Magnesium - therapeutic use magnesium deficiency Male Medical sciences Middle Aged Pharmacology. Drug treatments Potassium - blood Retrospective Studies Sodium Chloride Symporter Inhibitors - therapeutic use Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Tacrolimus - therapeutic use thiazide diuretic |
| title | Interaction of cyclosporine and FK506 with diuretics in transplant patients |
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