Syed Haider Nawaz, Mirza Naqi Zafar, Syed Ali Anwar Naqvi, Syed Adibul Hasan Rizvi.
Impact of Cyclosporin immunosuppression on serum Magnesium and its fractional excretion in Renal Transplant recipients.
J Pak Med Assoc Jan ;55(3):98-100.

Objective: To evaluate the effect of cyclosporine (CSA) on serum magnesium and its fractional excretion in renal transplant recipients. Methods: A cross sectional comparative study on 50 live related renal transplant recipients on GSA therapy with serum creatinine <2.0 mg/dl and 30 healthy controls. Serum creatinine, magnesium and its fractional excretion and CSA levels were monitored. Patients were followed at 6 months. Results: The mean serum creatinine in patients was 1.41 ± 0.42 mg/dl, cyclosporine 210 ± 66 ng/ml at a dose of 4.8 ± 1.4 mg/kg/day. The serum magnesium was 1.77± 0.32mg/dl vs 1.98 ± 0.17mg/dl in healthy controls (p<0.05). Fractional excretion was 5.05 ± 2.53% in patients vs 2.8 ± 1.05% in controls (p<0.05). No correlation was found between CSA levels (100-400 ng/ml) and serum magnesium (r = 0.053) or FEMg % (r = 0.215). Of the 50 recipients 27 (54%) had FEMg % in the control range. At 6 months follow up no difference in CSA levels was found between recipients with FEMg % in the normal range vs those with FEMg >5%. However, serum creatinine increased from 1.42 ± 0.30 mg/dl to 1.68 ± 0.82mg/dl (p< 0.05). Conclusion: CSA therapy lowers serum magnesium as compared to healthy controls and there is marked increase in FEMg% in 50% of the patients. Patients with FEMg >5% developed renal function deterioration. FEMg percent can thus be a good follow up marker of GSA chronic toxicity in stable transplant recipients.

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