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Cyclosporine nephrotoxicity
Emmanuel A Burdmann1, Takeshi F Andoh, Luis Yu
1Division of Nephrology, São José do Rio Preto Medical School, São José do Rio Preto, Brazil. burdmann@famerp.br
Abstract:
After more than 20 years of cyclosporine use its nephrotoxicity remains a significant clinical problem. Cyclosporine-induced renal injury has been described in solid organs recipients and in patients treated for autoimmune diseases. It is manifested in 2 distinct and well characterized forms, acute nephrotoxicity and chronic nephrotoxicity. This communication reviews the current literature analyzing the available data about the pathogenesis and mechanisms of acute and chronic cyclosporine-induced nephrotoxicity. A working hypothesis for the possible mechanisms of chronic cyclosporine nephrotoxicity will be provided.
Insights
Cyclosporine (CsA) nephrotoxicity is a persistent clinical issue, presenting as acute and chronic kidney injury in transplant recipients and autoimmune disease patients. This review explores CsA
Area of Science:
- Nephrology
- Immunology
- Pharmacology
Background:
- Cyclosporine (CsA) has been used for over two decades, but its significant nephrotoxicity remains a major clinical challenge.
- CsA-induced renal injury is observed in solid organ transplant recipients and patients undergoing treatment for autoimmune diseases.
- This nephrotoxicity presents in two distinct forms: acute and chronic.
Purpose of the Study:
- To review the current literature on the pathogenesis and mechanisms of acute and chronic cyclosporine-induced nephrotoxicity.
- To provide a working hypothesis for the potential mechanisms underlying chronic CsA nephrotoxicity.
Main Methods:
- Comprehensive review of existing scientific literature.
- Analysis of available data concerning the pathogenesis of CsA nephrotoxicity.
- Synthesis of information to propose mechanisms for chronic CsA nephrotoxicity.
Main Results:
- The review consolidates current knowledge on the dual forms of CsA nephrotoxicity.
- It highlights the ongoing need to understand the complex mechanisms driving renal injury.
- A novel working hypothesis for chronic CsA nephrotoxicity is presented for further investigation.
Conclusions:
- Cyclosporine-induced nephrotoxicity, both acute and chronic, continues to be a significant clinical concern.
- Further research into the specific mechanisms is crucial for mitigating renal damage.
- The proposed hypothesis offers a framework for future studies aimed at preventing and treating CsA nephrotoxicity.