title: Nephrotoxic aspects of cyclosporine.
abstract: Over the last 20 years cyclosporine (CsA) has improved the survival of kidney, heart, and liver transplants. However, with increasing use, evidence has accumulated that CsA therapy carries a variety of side effects, the most important being renal toxicity. CsA can lead to a wide spectrum of renal function impairments, including a marked and rapidly reversible decrease in renal hemodynamics (acute CsA nephrotoxicity), and a chronic form of renal damage that potentially progress irreversibly to end-stage renal disease (chronic CsA nephrotoxicity). All these manifestations are the consequence of the drug toxic effects on renal vessels and the tubulointerstitium. A proper diagnosis of CsA toxicity at early stages, the combination of low CsA doses with non-nephrotoxic immunosuppressants, and the development of more feasible strategies to monitor daily CsA exposure may contribute to a better CsA management, improve quality of life of transplant recipients, and prolong graft survival.
authors.affiliation: Department of Medicine and Transplantation, Ospedali Riuniti di Bergamo, Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Cattaneo
authors.forename: N
authors.initials: N
authors.lastname: Perico
authors.forename: F
authors.initials: F
authors.lastname: Gaspari
authors.forename: G
authors.initials: G
authors.lastname: Remuzzi
mesh_terms: D002908:Chronic Disease; D016572:Cyclosporine / Q000633:toxicity*; D006463:Hemolytic-Uremic Syndrome / Q000139:chemically induced; D006801:Humans; D007166:Immunosuppressive Agents / Q000633:toxicity; D007668:Kidney / Q000187:drug effects / Q000473:pathology*; D016030:Kidney Transplantation / Q000276:immunology; D012084:Renin-Angiotensin System / Q000187:drug effects
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine