Chronic cyclosporin-induced nephropathy.
OBJECTIVE
There is still no consensus about the prognostic influence of chronic nephropathy induced by low-dose maintenance therapy with cyclosporin. Our aim was to investigate the prognostic effect of cyclosporin nephropathy in Japanese renal transplant recipients.


METHODS
We retrospectively investigated the clinical records of 1,323 kidney transplant recipients who received cyclosporin at 65 institutions in Japan from 1982 to 1991.


METHODS
Renal biopsy was performed in 461 patients.


RESULTS
At 5 years and 9 years after transplantation, the patients who had cyclosporin nephropathy associated with immunological rejection, glomerulonephritis, or both showed a significantly worse prognosis than those with cyclosporin nephropathy alone (p < 0.01). There was no significant difference in the loss of renal function at 9 years after transplantation between patients showing no abnormalities and patients with cyclosporin nephropathy alone. Even when cyclosporin nephropathy was absent, the long-term prognosis was unfavorable in recipients with immunological rejection or glomerulonephritis.


CONCLUSIONS
These results suggest that cyclosporin nephropathy does not influence the prognosis of renal transplantation in patients on low-dose maintenance therapy with cyclosporin.
Takahara
S
S
Department of Urology, Osaka University School of Medicine, Suita-shi, Japan. takahara@uro.med.osaka-u.ac.jp
Ota
K
K
Takahashi
K
K
Uchida
K
K
Morozumi
K
K
Wang
J D
JD
Kyo
M
M
D002908:Chronic Disease; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007668:Kidney / Q000187:drug effects / Q000473:pathology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000473:pathology; D016030:Kidney Transplantation; D011379:Prognosis; D012189:Retrospective Studies
D007166:Immunosuppressive Agents; D016572:Cyclosporine