and M.M.)
/viewarticle/936215
Long-term use of cyclosporine has been associated with patchy interstitial fibrosis, usually in a striped pattern and with tubular atrophy. Salvadori M, Tsalouchos A. Immunoglobulin G4-related kidney diseases: An updated review. Tacrolimus has been considered less nephrotoxic than cyclosporine, but direct quantitative comparisons of the changes in renal structure from baseline to follow-up biopsies have not been done. (See "Cyclosporine and tacrolimus nephrotoxicity".) To avoid the pitfalls of renal allograft studies, including rejection and disease recurrence, we compared the development of calcineurin lesions in the native kidneys of 14 tacrolimus– … We then compared serial creatinine clearance data for the two drugs for the whole study population using repeated measures analysis. Calcineurin inhibitors (CNI) improved early renal allograft survival and revolutionized transplantation of nonrenal organs, including heart, liver, lung, and pancreas. The GFR decline and the increase in interstitial fractional volume, tubular atrophy, and %GS in the TAC and CSA groups were similar in both absolute and relative terms. Clive DM, Vanguri VK.
and systemic hemodynamics, and cyclosporine levels within or below the therapeutic Cyclosporine may lead to adverse events such as nephrotoxicity, chronic hemolytic uremic syndrome, hyperlipidemia, hypertension, gingival hyperplasia, diabetes mellitus, and tremors. The efficacy and use of these agents in specific conditions, including organ transplantation and immune-mediated diseases, are discussed separately in the topic reviews addressing the treatment of each disorder. Nonetheless, the remarkable similarity in the nature and pace of these lesions, despite the marked differences in CSA and TAC molecular structure and target binding proteins (We previously reported that, although GFR decline from baseline to 12 months correlated with CSA dose, GFR remained stable thereafter, despite a lowering of CSA dose and blood levels (In conclusion, in PTA patients, the chronic nephrotoxic effects of TAC and CSA are similar in terms of both renal function and renal structure.This work was supported by grants from the National Institutes of Health (DK13083), the National Center for Research Resources (MO1-RR00400), an endowment from the Kroc Research Foundation, and an academic grant from Astellas.
We wish to thank Suzanne Meleg-Smith, MD, for her previous contributions to this article. This study evaluates the nephrotoxicity …
Kidney biopsy. We are most indebted to the patients who generously participated in these studies.Published online ahead of print.
De Broe ME. This image shows chronic tubulointerstitial nephritis. Results from the U. S. Multicenter TrialLong‐term outcomes in pediatric liver recipients. Compare Cyclosporine vs Tacrolimus head-to-head with other drugs for uses, ratings, cost, side effects, interactions and more. for estimation of the fraction of the vascular profile occupied by hyaline (Tissue for electron microscopy was processed and measured as previously detailed (Results are expressed as mean ± SD, except for AER, which not normally distributed, is expressed as median and range. Acute crescentic glomerulonephritis.
Data for individual patients are connected by lines.The increase in %GS from 6.1% ± 7.5% to 30% ± 17.2% (392%, Percentage of globally sclerosed glomeruli at baseline and 5 years after PTA in TAC- and CSA-treated groups. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly93d3cubWVkc2NhcGUuY29tL2Fuc3dlcnMvMjQzNTk3LTExNTgyMS93aGF0LWFyZS1jeWNsb3Nwb3JpbmUtLWFuZC10YWNyb2xpbXVzLWluZHVjZWQtbmVwaHJvcGF0aHk= Thrombotic microangiopathy might further contribute to both acute and chronic nephrotoxicity.Joyce E, Glasner P, Ranganathan S, Swiatecka-Urban A. Tubulointerstitial nephritis: diagnosis, treatment, and monitoring.