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Background: Cyclosporine
is one of the main immunosuppressors used for renal transplant recipients, and
is given to prevent transplant rejection. Although the drug increases the
survival of patients and grafted organs, it has some side effects independent
of its effect on the immune system that are usually ignored. In this study, we
evaluate the effect of cyclosporine on serum Mg levels and metabolic side
effects in renal graft patients.
Methods: In this study, we followed 157 renal
transplant recipients (62 females and 95 males) who were being treated with cyclosporine at a
private clinic to prevent transplant rejection. The patients were first physically
examined and then blood samples were obtained in order to measure levels of
cyclosporine, Mg, creatinine, fasting blood sugar, lipids, calcium,
phosphorus, and uric acid levels. We then analyzed the data for correlations between
serum Mg
levels, cyclosporine and other metabolic complications.
Results: The mean levels of Mg and
cyclosporine were 196±0.31mg/dl and 371±192 μg/dl, respectively. Hypomagnesemia was detected in 16 patients (10.2%).There was
a significant negative correlation (p<0.05) between levels of Mg and cyclosporine levels (r=-0.53), serum
creatinine (r=-0.61), plasma LDL (r=-0.3), fasting blood sugar (r=-0.60) and uric
acid (r=-0.36), and no correlation (p>0.05) between levels of Mg and calcium (r=0.2), phosphorus (r=-0.01),
triglycerides (r=0.06) and HDL (r=-0.08). Mean levels of cyclosporine, creatinine, LDL, fasting
blood sugar and uric acid in patients with hypomagnesemia were significantly
different from those patients with normal serum Mg levels (p<0.05). There
was no significant difference between the two groups with regard to mean total
cholesterol, HDL, calcium and phosphorus (p>0.05).
Conclusion: According to the results of this and previous studies,
there is a significant correlation between cyclosporine levels and
hypomagnesemia as well as other biomedical complications secondary to
hypomagnesemia. Therefore, we recommend routine serum Mg determination and greater
attention to hypomagnesemic patients to prevent further complications.
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