Clinical results and cyclosporine effect on prednisolone metabolism of cadaver kidney transplanted patients.

In the first randomised study of cyclosporine in Denmark 43 cadaveric kidney recipients were treated either with cyclosporine (Cys) and prednisone or azathioprine (Aza) and prednisone. The degradation of prednisolone was examined in 18 of these patients. The 12 month graft survival of the Cys group was not significantly greater than that of the Aza group (68% and 60%, respectively), but fewer rejection episodes occurred in the Cys group (p less than 0.05). The degradation of prednisolone was significantly decreased in the Cys group compared to the Aza group. Accordingly, plasma half-lives of prednisolone were increased in the Cys group compared with the Aza group. As a decreased degradation of prednisolone during Cys treatment may lead to increased steroid activity, we recommend that a reduction of the prednisone dosage during Cys treatment is safe.