title: Effects of cyclosporine on bone mineral density in patients with glucocorticoid-dependent nephrotic syndrome in remission.
abstract: OBJECTIVE
  Cyclosporine (CsA) is often prescribed to patients with glucocorticoid (GC)-dependent nephrotic syndrome. Although it is well known that long-term administration of GC causes osteoporosis, the effects of CsA on bone metabolism are not fully established. Therefore, we examined the effects of CsA on bone metabolism in patients with GC-dependent nephrotic syndrome in remission.
  
  
  METHODS
  We followed 23 patients treated with prednisolone alone (GC alone group) and 17 patients treated with CsA in combination with prednisolone (GC + CsA group). Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and biochemical markers of bone metabolism were simultaneously measured in serum and urine samples.
  
  
  RESULTS
  BMD decreased significantly in the GC group from 752 to 623 mg/cm(2) but non-significantly in the GC + CsA group from 751 to 684 mg/cm(2). Although the cumulative dose of GC increased in both groups, there were no significant differences in biochemical markers at either the start or the end of the study. Vertebrate bone fracture and other side effects associated with CsA treatment did not occur in our study.
  
  
  CONCLUSIONS
  Our results indicate that CsA does not accelerate GC-induced osteoporosis in patients with nephrotic syndrome. We conclude that CsA is appropriate for the treatment of GC-dependent nephrotic syndrome, because it does not adversely affect bone metabolism and has favorable glomerular effects.
authors.affiliation: Department of Nephrology, Hypertension and Endocrinology, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashiku, Tokyo, 173-8610, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Shimizu
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fujita
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Fuke
authors.forename: Minako
authors.initials: M
authors.lastname: Yabuki
authors.forename: Mamiko
authors.initials: M
authors.lastname: Kajiwara
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Hemmi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Satomura
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Soma
mesh_terms: D015502:Absorptiometry, Photon; D000284:Administration, Oral; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D016572:Cyclosporine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D010024:Osteoporosis / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine