Effect of Cyclosporine on the Rate of Renal Function Recovery After Renal Transplantation

To assess the effect of cyclosporine therapy on the rate of renal function recovery after renal transplantation, patients with no clinical evidence of rejection and who were treated with either cyclosporine or azathioprine in addition to steroid therapy were studied (n = 74). Of the patients with immediate renal function (n = 57), those receiving organs from living, related donors had a faster recovery rate of glomerular filtration than patients with cadaveric grafts (azathioprine, 15 ± 2 versus 7 ± 1 mL/min/day, P = 0.0001; cyclosporine, 14 ± 3 versus 6 ± 1 mL/min/day, P = 0.001). Recipients of cadaveric grafts with delayed renal function (n = 17) had a decreased recovery rate of allograft function when treated with cyclosporine as compared to those treated with azathioprine (4 ± 2 versus 6 ± 1 mL/min/day, respectively; P = 0.026). Patients on azathioprine achieved better renal function (P = 0.01) than those on cyclosporine (recipients of organs from living, related donors, 59 ± 5 versus 52 ± 3 mL/min; recipients of cadaveric grafts, 52 ± 5 versus 40 ± 2 mL/min). Thus, even in this early period, cadaveric-graft recipients treated with cyclosporine demonstrate an apparent reduction in creatinine clearance when compared to patients treated with azathioprine