At present, most transplant centers use triple immunosuppressive regimens based on calcineurin inhibitors, namely cyclosporine A or tacrolimus plus auxiliary drugs such as azathioprine and mycophenolate mofetil , rapamycin, imidazole rabinal corticosteroids.
Nephrotoxicity is one of the most important side effects of cyclosporine a. It has various manifestations, including short-term, functional and acute organic diseases, and chronic nonprogressive or chronic progressive renal dysfunction. Cyclosporine A can cause mild liver damage, and the extent of liver damage is related to the dose of cyclosporine A. It can be normal after reduction or withdrawal.
The nephrotoxicity of tacrolimus was lower than that of cyclosporine a, and the degree of hypertension was less than that of cyclosporine a. There were no reports of hyperlipidemia and hyperuricemia. The main side effects are toxic to the central nervous system and islet function.
The side effects of azathioprine are mainly toxic side effects in the bone marrow hematopoietic system, digestive system and so on. Azathioprine can cause leukopenia, and sometimes it can also cause whole bone marrow suppression, including thrombocytopenia and red blood cell dysregulation. Azathioprine can cause liver damage, and it can easily cause bone marrow suppression in the presence of acute or chronic liver disease.
The main adverse effects of metocophenolate mofetil include gastrointestinal reactions, bone marrow suppression, and certain infectious diseases. Mycophenolate mofetil can cause gastrointestinal reactions such as nausea, vomiting, gastritis, anorexia, diarrhea, and severe gastrointestinal bleeding. Mycophenolate mofetil can also cause leukopenia and sometimes whole bone marrow suppression including thrombocytopenia and red cell regeneration disorders.
Midazolipin also suppresses bone marrow, but is lighter than azathioprine and motimefen. Mizoribine is not metabolized in the liver and is not toxic to the liver. Another major toxic side effect of imidazolin is elevated serum uric acid, which can be corrected by adding allopurinol.
The side effects of rapamycin include fatigue, dizziness, high blood pressure, elevated serum cholesterol and triglyceride levels, and thrombocytopenia. Rapamycin has little effect on liver and kidney function.
The side effects of glucocorticoids have negative effects on the long-term and prognosis of grafts. Acute side effects include: changes in the central nervous system, such as depression or mania, sleep disorders, etc.; induce and aggravate islet cell function damage, hypertension, and high blood lipids. Long-term medication can produce Cushing's syndrome, hirsutism, acne, cataracts, bone and muscle disorders, stunted children, and increased risk of infection.上一篇：What are the benefits of milk for kidney patients?