Cyclosporine-A-induced nephrotoxicity in children with minimal-change nephrotic syndrome: long-term treatment up to 10 years

Pediatric Nephrology : Journal of the International Pediatric Nephrology Association
Birgitta KranzP F Hoyer

Abstract

The impact of cyclosporine A (CsA) therapy in patients with steroid-dependent nephrotic-syndrome (SDNS) on long-term renal function is controversial. Data beyond 5 years are rare. Long-term renal function was evaluated in children with SDNS with and without CsA therapy, especially beyond 5 years. Twenty children were treated with CsA (study group) for a mean of 5.4 +/- 2.2 years (ten patients for 5-11 years). Glomerular filtration rate (GFR) was calculated before and after 3 and 12 months and at latest follow-up of therapy. Fifteen children with cyclophosphamide-treated SDNS without CsA served as controls. In the study group, GFR decreased within 12 months from 136 +/- 19 to 120 +/- 31, to 114 +/- 14 ml/min per 1.73 m(2) at latest follow-up (p < 0.0001). Patients with CsA > 5 years had a GFR of 111 +/- 14 ml/min per 1.73 m(2) at latest follow-up without a GFR below 90 ml/min per 1.73 m(2). No CsA toxicity was found in biopsies. In the control group, GFR dropped within 3 months, from 137 +/- 27 to 130 +/- 24, to 126 +/- 19 ml/min per 1.73 m(2) at latest follow-up (p = 0.1). Patients with and without nephrotoxic CsA therapy showed a drop in GFR. In CsA-treated patients, GFR was about 12% lower at latest follow-up compared with pa...Continue Reading

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Citations

May 8, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Koichi KameiKazumoto Iijima
Dec 15, 2012·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Takashi TakeiKosaku Nitta
Aug 10, 2010·Nephron. Clinical Practice·Hidekazu SugiuraKosaku Nitta
Dec 4, 2013·American Journal of Nephrology·Takahisa KimataKazunari Kaneko
Jul 25, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Severin Kengne-WafoFrancesco Emma
Apr 13, 2013·Indian Journal of Nephrology·A SinhaA Bagga
Jun 1, 2012·Kidney International Supplements
Jul 21, 2011·Pediatrics International : Official Journal of the Japan Pediatric Society·Kazumoto Iijima
Feb 6, 2015·Clinical and Experimental Nephrology·Kenji IshikuraUNKNOWN Japanese Society for Pediatric Nephrology
Jan 8, 2014·Experimental and Therapeutic Medicine·Xiang GaoChenggang Xu

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