Sustained renal function loss in psoriasis patients after withdrawal of low-dose cyclosporin therapy.
Eight patients with psoriasis received low-dose cyclosporin (CyA) treatment for an average period of 12 months (range 4-16 months). There was great variability in minimal effective CyA dose. In 50% of the patients long-term treatment was limited by dose reductions necessitated by side-effects. A considerable impairment of renal function during CyA therapy was found. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured with 125I-iothalamate and 131I-hippuran, respectively. Both at the end of the active treatment period (GFR-CyA and ERPF-CyA), and 4 months after withdrawal of CyA (GFR-4mo and ERPF-4mo), there was sustained renal impairment: GFR-BL = 97 (64-117), GFR-CyA reduction 17.8% (2.2-31.9%) [P < 0.02], GFR-4mo reduction = 9.8% (5.5-21.5%) ml/min/1.73 m2 (P < 0.05 vs. BL); ERPF-BL = 401 (232-607), ERPF-CyA reduction = 10.1% (7.4-27.3%) [P < 0.05], ERPF-4mo reduction = 13.5% (3.0-32.9%) ml/min/1.73 m2 (P < 0.02). Further studies of the effects on renal function during, and after, long-term therapy of psoriasis with low-dose CyA are warranted.
Korstanje
M J
MJ
Department of Dermatology, University Hospital, Leiden, The Netherlands.
Bilo
H J
HJ
Stoof
T J
TJ
D000328:Adult; D003524:Cyclosporins / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007668:Kidney / Q000098:blood supply; D007674:Kidney Diseases / Q000139:chemically induced* / Q000503:physiopathology; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D012039:Regional Blood Flow / Q000187:drug effects; D013375:Substance Withdrawal Syndrome
D003524:Cyclosporins