Changes in renal function and side-effect profile after conversion from tacrolimus to cyclosporine in kidney transplant recipients: A single-centre retrospective descriptive analysis

Background: Tacrolimus and cyclosporine are commonly used calcineurin inhibitors in kidney transplantation. In resource-limited settings, conversion between agents may occur due to drug availability, cost, or intolerance. Data on renal outcomes and adverse effects following conversion are limited in South Asia.
Methods: This retrospective descriptive analysis included adult kidney transplant recipients at a single Sri Lankan centre who were converted from tacrolimus to cyclosporine in 2023. Data collected included demographics, transplant characteristics, renal function [serum creatinine (mg/dl), eGFR], infections, and documented adverse effects. Renal function was assessed at baseline, 6 months, and 12 months post-conversion. Descriptive statistics were used: mean ± SD for continuous variables; percentages for categorical variables. Comparisons were descriptive due to the small sample size.
Results: Forty-four patients were included (mean age 49 years; 65.9% male). Most had received living donor transplants (79.5%) and had undergone transplantation more than two years prior to conversion. The most common reasons for conversion were tacrolimus unavailability, cost constraints, and drug intolerance. Mean serum creatinine and eGFR remained broadly stable over the 12-month follow-up period after conversion. Documented infections included COVID-19 infection, urinary tract infections, and other viral and bacterial respiratory tract infections. Gastrointestinal and cosmetic adverse effects were reported in a subset of patients; however, documentation of cosmetic adverse effects was incomplete in some clinical records.
Conclusion: In this single-centre retrospective analysis, conversion from tacrolimus to cyclosporine was associated with stable short-term renal function based on available records. These findings reflect real-world practice in a resource-limited setting but should be interpreted cautiously due to the descriptive design and limited sample size.