Effects of Cyclosporine A on Pancreatic Insulin Secretion

Our primary aim is to investigate if cyclosporine A may reduce insulin secretion by 20% or more. In order to get cyclosporine A naïve patients we will perform this investigation in dialysis patients on the waiting list for a renal transplantation. In addition we will investigate if also the peripheral insulin sensitivity and endothelia function is affected by cyclosporine A treatment in these patients. Since these patients will be treated with cyclosporine A we will also measure cyclosporine pharmacokinetics at the time of investigation and repeat this investigation at the time of the first week following transplantation in order to evaluate if a pretransplant cyclosporine dose can be of value in predefining the dose to be used at the time of transplantation.

glucose intolerance, insulin, microvascular function, genotyping, CYP3A5, pharmacokinetics, renal transplantation

Inclusion Criteria: Renal failure patients on dialysis which is planned to receive a renal transplant Exclusion Criteria: Age below 18 years or above 75 years Pregnancy Breast feeding mothers Diabetes mellitus /WHO criteria) Dialysis treatment less than 2 months Serious coronary heart disease Unstable angina pectoris Recent acute infarction (less than 3 months) Non-compensated heart failure Simultaneous treatment with glucocorticosteroids (e.g. prednisolone, dexamethasone), diltiazem, verapamil, erythromycin, clarithromycin, telithromycin, rifampicin, fluconazole, itraconazole, ketoconazole, voriconazole, indinavir, nelfinavir, ritonavir, nefazodone, bosentan, carbamazepine, St. John's worth, grapefruit.