Prevention of calcineurin inhibitor nephrotoxicity in renal transplantation.
Calcineurin inhibitors (CNI) cyclosporine (Csa) and tacrolimus (Tac) are now first intention immunosuppressive drugs in renal transplantation. However, although these treatments are effective for preventing allograft rejection, they are nephrotoxic: they can cause chronic renal dysfunction and degradation of renal graft function [Nankivell BJ, et al. The natural history of chronic allograft nephropathy. N Engl J Med. 2003 Dec 11;349(24):2326-33]. In view of these undesirable effects, several strategies have been developed to minimize or even avoid their use. These strategies are reviewed and discussed in this paper.
Jacquet
A
A
Nephrology Department, Université Paris Sud, France.
Francois
H
H
Frangie
C
C
Ahmad
L
L
Charpentier
B
B
Durrbach
A
A
D000911:Antibodies, Monoclonal / Q000276:immunology / Q000627:therapeutic use; D000077552:Basiliximab; D065095:Calcineurin Inhibitors; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D006084:Graft Rejection / Q000188:drug therapy; D006085:Graft Survival / Q000187:drug effects / Q000276:immunology; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016030:Kidney Transplantation; D011993:Recombinant Fusion Proteins / Q000276:immunology / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000209:etiology / Q000517:prevention & control*; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects*
D000911:Antibodies, Monoclonal; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents; D011993:Recombinant Fusion Proteins; D016572:Cyclosporine; D000077552:Basiliximab; D016559:Tacrolimus