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

journal contribution
posted on 2023-05-16, 16:08 authored by Melanie BlackhallMelanie Blackhall, Fassett, RG, James SharmanJames Sharman, Dominic GeraghtyDominic Geraghty, Coombes, JS
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 â-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 ìg/ml) compared with no change while taking the placebo (pre- 132.2±50.6, post- 138.6±56.0 ìg/ml). The glomerular filtration rate was significantly (P<0.05) improved by 12% during antioxidant supplementation (pre- 66.9±20.7, post- 75.0±20.1ml/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.

History

Publication title

Nephrology, Dialysis and Transplantation

Volume

20

Issue

9

Pagination

1970-1975

ISSN

0931-0509

Department/School

Tasmanian School of Medicine

Publisher

Oxford Univ Press

Place of publication

Great Clarendon St, Oxford, England, Ox2 6Dp

Rights statement

The definitive publisher-authenticated version is available online at: http://www.oxfordjournals.org/

Repository Status

  • Restricted

Socio-economic Objectives

Clinical health not elsewhere classified

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    University Of Tasmania

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