الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 126 |  |  |
| | | from | 126 | | |
Abstract
End-stage renal disease is the leading cause of premature death; kidney transplant is the best choice for ESRD and it decreases the mortality rate.
A combinatorial approach have emerged involving different immunosuppressive drugs such as calcineurin inhibitors (CNIs), anti-proliferative agents (commonly mycophenolate mofetil) and steroids. Immunosuppressive drugs have many side effects most of them occur in the gastrointestinal (GI) tract.
Gastrointestinal complications occur in almost 40% of organ recipients. These include infection, malignancy, and mucosal injury. Which are manifested as diarrhea, nausea, vomiting, abdominal pain, and GI bleeding.
Proton Pump Inhibitors (PPIs) are prescribed to counteract the risk of gastrointestinal complications in renal transplantation recipients. As the most commonly used PPIs in Egyptian renal transplantation centers are pantoprazole and esomeprazole. So the main aim was to compare between pantoprazole and esomeprazole influence on cyclosporine (CsA) serum levels in stable renal transplant recipients on triple immunosuppressive therapy.
Seventy candidates were eligible and recruited, and only 47 completed the study (11 did not comply with treatment, and 12 were lost to follow-up), which was conducted from January till September 2016. Participants were randomized into two groups
group I: Esomeprazole a 40 mg/day (Copad Pharma, Cairo, Egypt) (n = 25 at study completion)
group II: Pantoprazole a 40 mg/day (Pharo Pharma, Alexandria, Egypt) (n = 22 at study completion). Blood samples were collected before the cyclosporine dose to assess the trough CsA levels (C0).
Summary
Ph.D. Thesis 2020 Page 71
In the current study it was found that
Co-administration of esomeprazole showed a decrease in the CsA trough levels more than pantoprazole of the same dose by the end of the study at 6 months.
In the esomeprazole group WBCs count showed significance decrease at 6th month more than 1st month.
As for the serum creatinine level as an estimator of renal function in these patients the esomeprazole group