同種腎移植の拒絶反応における腎血管拡張剤の効果について --Benzothiazepine誘導体(CRD-401)の実験ならびに臨床成績--

Abstract

Experimental and clinical studies have been carried out to evaluate the effect of vasodilator on the renal allografts. It has been shown that renal blood flow is increased by administration of benzothiazepine derivative (CRD-401) in ischemic and hypotensive states. Administration of Imuran combined with CRD-401 could obtain the efficient renal blood flow experimentally. This suggests that some vasodilators are able to reduce the development of allograft rejection or to protect the ischemic renal damage due to rejection. According to these findings, the agent has been used in three patients at the time of clinical rejection with and without using a large quantity of immunosuppressive drugs. One case was recovered from the rejection soon after oral administration of the benzothiazepine derivative (100 mg/day) associated with improvement of renogram pattern and hypertension, as well as marked increase of sodium excretion. In the second case, who had hypertension remaining even after the recovery from early rejection crisis, both hypertension and hyponatriuresis were quite improved only by CRD administration. Renal ischemia, especially cortical ischemia, results in reduction of sodium excretion. Vasodilators, such as CRD, have the effect of increasing the cortical blood flow and sodium excretion. Therefore, these findings suggest that the clinical application of vasodilator agents is to be a new addition to the treatment for early rejection of kidney allograft.