#3271 Effect of immunosuppressive therapy with cyclosporine on arterial stiffness in patients with glomerulonephritis

Abstract Background and Aims Immunosuppressive treatment with cyclosporine has been the main therapeutic option in patients with glomerulonephritis, mainly with membranous nephropathy, in the past decades. Chronic administration of cyclosporine is associated with glomerulosclerosis and arterial hypertension. The aim of the present study was to determine whether cyclosporine administration could cause deterioration of arterial stiffness indices. Method In this prospective open label cohort study, we included 140 patients (93 males) with a medical history of primary or secondary glomerulonephritis, who were divided into three groups according to whether they had received cyclosporine during the study, in the past, or had never received cyclosporine as immunosuppressive therapy. Participants were followed as outpatients every three to six months for 2 years. During their visits, all the participants underwent central blood pressure (cBP) and pulse wave velocity (PWV) measurements with mobli-O-graph device, while basic laboratory testing was performed at each visit. Results Twenty patients (M:F = 12:8) were receiving immunosuppressive treatment with cyclosporine during the study, 31 (M:F = 21:10) had received cyclosporine in the past, while 90 patients (M:F = 60:30) had never received cyclosporine. The three groups did not differ in terms of mean age (52.1 ± 17.5 vs 57.7 ± 11.3 vs 52.9 ± 16.6 years, respectively, P = 0.288), the presence of diabetes mellitus, arterial hypertension, and heart failure. Accordingly, PWV was higher in the group receiving cyclosporine during the study compared to the group that had received in the past, while patients who had never received cyclosporine had the lowest PWV values ​​[8.5 (6.7–9.6) vs 8.0 (7.0–9.9) vs 7.5 (6.1–9.4) m/sec, respectively, P = 0.023]. Regarding cSBP, patients receiving cyclosporine during the study had a higher median value compared to those who had previously received or had never received cyclosporine; however, the difference was not statistically significant [120.3 (109.9–136.5) vs 117.3 (105.9–124.4) vs 118.0 (109.1–130.4), respectively, P = 0.120]. Conclusion Immunosuppressive therapy based on cyclosporine, a popular treatment option especially for patients with membranous nephropathy, could worsen arterial stiffness indices.