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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

Seminars in Nephrology
|September 19, 2003
PubMed
Summary
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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.

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  • 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.