Nephrotoxic aspects of cyclosporine.
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.
Cattaneo
D
D
Department of Medicine and Transplantation, Ospedali Riuniti di Bergamo, Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
Perico
N
N
Gaspari
F
F
Remuzzi
G
G
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
D007166:Immunosuppressive Agents; D016572:Cyclosporine