SIDE EFFECTS OF CYCLOSPORINE COMPARED TO TACROLIMUS AMONG YEMENI KIDNEY TRANSPLANT PATIENTS WHO SHARE THE SAME ADJUVANT AGENTS: MYCOPHENOLATE MOFETIL AND PREDNISONE

Ibtesam Abdullah Al-Akwa’a; Nagieb Waza'a Abu Asba; Khaled Abdl Karim Al-Moyed; Hassan Abdul Wahab Al-Shamahy; Ahmed M. Al-Haddad

doi:10.22270/ujpr.v5i5.484

Ibtesam Abdullah Al-Akwa’a The National Center for Public Health Laboratories in Sana'a, The Ministry of Health and Population, Sana’a, Yemen.
Nagieb Waza'a Abu Asba Urology and Nephrology Center, Al-Thawra Hospital, Sana’a University, Sana'a, Yemen.
Khaled Abdl Karim Al-Moyed Department of Medical Microbiology and Clinical Immunology, Faculty of Medicine and Health Sciences, Sana'a University, Yemen.
Hassan Abdul Wahab Al-Shamahy Department of Medical Microbiology and Clinical Immunology, Faculty of Medicine and Health Sciences, Sana'a University, Yemen
Ahmed M. Al-Haddad Department of Medical Laboratories, College of Medicine and Health Sciences, Hadhramout University, Al-Mukalla, Yemen

10.22270/ujpr.v5i5.484

Keywords:

Cyclosporine, mycophenolate mofetil, prednisone, renal transplant, side effects, tacrolimus, Yemen

Abstract

Background: A renal allograft is the optimum therapeutic option for patients with end stage renal diseases. Nevertheless, rejection still represents a large challenge. So as to overcome this matter, treatment strategies comprise the combined use of anti-inflammatory and immunosuppressive agents, although they are not free from complications . Interestingly, the major cause of morbidity and mortality after the first transplanted year are due to disorders unrelated directly to immunologic etiology or disease related to immunosuppressive drugs.

Objectives: The purpose of this study is to determine the side effects in renal transplant Yemeni patients adherence to cyclosporine compared to tacrolimus sharing the same adjuvant agents which are mycophenolate mofetil "MMF" and prednisone.

Subject and methods: This prospective study was carried on 100 kidney transplanted Yemeni patients divided into two groups: cyclosporine group (n=50) and tacrolimus group (n=50), each member of these groups was visited three times, blood samples were collected for biochemical functions including fasting blood sugar, liver enzymes, kidney functions, lipid profiles and white blood cells counts and results were obtained from the tests performed. Body weight and blood pressure had been examined; clinical complications were also recorded.

Results: This study showed that serum total and direct bilirubine, gamma glutamyl transferase "GGT" and lipid profiles were elevated in cyclosporine group, whereas in tacrolimus group they were within normal range. The incidence of complicated events reported as follows: Hairtusim, gum hyperplasia, herpeszoster, CUSHING face and obesity were obviously present in cyclosporine group, while in tacrolimus group diabetes mellitus, hair loss and gastrointestinal tract infections were in existence.

Conclusion: This study found that a tacrolimus-based treatment was significantly better than an immunosuppressive regimen based on cyclosporine due to the generally less side effects associated with tacrolimus, despite its effect on increasing diabetes among kidney transplant patients.