Herbal teas interfere with cyclosporin levels in renal transplant patients

Extract

Dialysis-Centers 1Lindau/Bodensee and 2Immenstadt i.Allgäu, Germany

Introduction

After a successful renal transplantation, a high fluid intake of 2–3 l daily is generally advised to achieve a steady urine flow. To reach that goal, dieticians recommend herbal teas, since they regard them as biologically inert; in contrast to black tea, coffee, alcoholics or commercial fruit juices, which are either psychotropic or rich in calories.

However, herbal teas contain plant constituents of biological relevance for the consumer, and especially for transplanted patients treated with immunosuppressive medication.

We present here three renal transplant patients who drank herbal teas with a marked influence on cyclosporin metabolism.

Cases

The first patient was a 48-year-old woman (weight 56 kg, height 165 cm) who received a cadaveric renal allograft in September 2000. After two severe rejection episodes, graft function had stabilized at a serum creatinine of 1.2–1.4 mg/dl and she received maintenance immunosuppression with cyclosporin, mycophenolate mofetil (MMF) and tapered steroids which were discontinued after 14 months. Her additional medication consisted of pravastatin, valsartan and hydrochlorothiazide.