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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research
Evelin Veronike
Nephrology Division, Department of Uronephrology, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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Calcium Channel Blockers in Kidney Transplant Recipients: Cyclosporine-Era Kidney-Function Effects and Tacrolimus Pharmacokinetic Implications: A Meta-Analysis Harnavi Harun; Evelin Veronike; Garri Prima Decroli; Muhammad Ridhwan Fatharanifurqan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 9 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i9.1656

Abstract

Background: Post-transplant hypertension and calcineurin-inhibitor nephrotoxicity threaten cardiovascular and graft outcomes after kidney transplantation. Calcium channel blockers offer haemodynamic benefit and alter calcineurin-inhibitor exposure, but cyclosporine and tacrolimus studies assessed different evidence domains. Objective: To pool the comparative effect of calcium channel blockers on kidney-function outcomes in adult kidney transplant recipients, and to distinguish the cyclosporine-era kidney-function evidence from the tacrolimus-era pharmacokinetic implications. Methods: Comparative randomised trials and cohorts in adult kidney transplant recipients were identified through PubMed, the Cochrane Library, citation pathways, and reference checking. Kidney-function outcomes were directionally harmonised. Compatible standardised mean differences were pooled using a restricted maximum-likelihood random-effects model with Hartung–Knapp inference. Prediction intervals, subgroup analyses, influence diagnostics, sensitivity analyses, and Cochrane RoB 2 assessments were completed. Results: At least 22 reports represented at least 21 independent datasets; seven cyclosporine-treated trials with 639 participants supplied compatible kidney-function data. Calcium channel blockers were favoured (Hedges g 0.38, 95% CI 0.11 to 0.66; I²=45.2%; τ²=0.042), although the 95% prediction interval ranged from −0.19 to 0.96. Leave-one-out estimates ranged from 0.26 to 0.45. DerSimonian–Laird and critical-risk sensitivities yielded g 0.38 and 0.37. A tacrolimus clinical subgroup and primary Egger test were not estimable. Conclusion: Calcium channel blockers were associated with modestly better kidney-function measurements during cyclosporine treatment, but very-low-certainty evidence precluded a uniform benefit claim. Tacrolimus evidence instead concerned CYP3A5-dependent exposure and dose sparing; the two evidence streams remain clinically linked but quantitatively non-equivalent.
Comparative Profiling of Arterial Stiffness and Radiocephalic Arteriovenous Fistula Morphology in Diabetic Versus Non-Diabetic Patients on Maintenance Hemodialysis Harnavi Harun; Garri Prima Decroli; Evelin Veronike; Muhammad Ridhwan Fatharanifurqan
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 11 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i11.1678

Abstract

Background: Diabetes mellitus accelerates cardiovascular deterioration in chronic kidney disease, but it is unclear whether it adds stiffness to the central arteries or affects the peripheral arteriovenous fistula (AVF) of hemodialysis patients. Objective: To compare central and peripheral pulse wave velocity (cfPWV, faPWV), renal resistive index (RI), and radiocephalic AVF diameter and volume flow between diabetic and non-diabetic hemodialysis patients. Methods: This analytical cross-sectional study included 120 prevalent hemodialysis patients (22 diabetic, 98 non-diabetic) at Dr. M. Djamil General Hospital in 2025. One blinded sonographer measured the vascular parameters by Doppler ultrasonography. Groups were compared with t-tests and chi-square tests, with 95% confidence intervals and Cohen's d. Results: Diabetic patients were older (56.4 ± 8.1 vs. 50.6 ± 9.4 years; p = 0.004) and had lower diastolic blood pressure (73.27 ± 9.84 vs. 79.72 ± 10.15 mmHg; p = 0.008). cfPWV (2.89 ± 0.57 vs. 2.90 ± 0.61 m/s; p = 0.941), faPWV (3.34 ± 0.73 vs. 3.15 ± 0.69 m/s; p = 0.236), and mean RI (0.825 ± 0.029 vs. 0.818 ± 0.033; p = 0.341) did not differ. AVF diameter was smaller in diabetic patients (1.74 ± 0.63 vs. 2.36 ± 0.74 mm; p < 0.001; Cohen's d = −0.86), whereas flow did not differ significantly (3489 ± 1018 vs. 3063 ± 945 mL/min; p = 0.072). Conclusion: Diabetes was associated with a smaller AVF diameter but not with higher central or peripheral stiffness or renal RI. Given the cross-sectional, unadjusted design, adjusted longitudinal studies are needed.
Co-Authors Garri Prima Decroli Harun Harnavi Muhammad Ridhwan Fatharanifurqan Muhammad Ridhwan Fatharanifurqan