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Calcineurin inhibitors and nephrotoxicity in children

Fei Liu1, Jian-Hua Mao2

  • 1Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

World Journal of Pediatrics : WJP
|March 14, 2018
PubMed

Insights

Calcineurin inhibitors (CNIs) are effective immunosuppressants but can cause kidney damage, particularly in children. Further research is needed to identify early markers and develop safer alternatives for CNI-related nephrotoxicity.

Area of Science:

  • Pediatric Nephrology
  • Transplantation Immunology
  • Pharmacology

Background:

  • Calcineurin inhibitors (CNIs) are vital immunosuppressants for organ transplant recipients and individuals with immune disorders.
  • Long-term nephrotoxicity is a significant clinical concern with CNIs, especially in pediatric patients due to their longer life expectancy.
  • Concerns are heightened in children with nephrotic syndromes, including steroid-resistant, steroid-dependent, and frequent relapse types.

Purpose of the Study:

  • To review and assess the existing evidence on calcineurin inhibitor (CNI)-induced nephrotoxicity in pediatric organ transplant recipients.
  • To evaluate the prevalence and severity of chronic CNI nephrotoxicity in children.
  • To identify research on early markers and management strategies for CNI nephrotoxicity.

Main Methods:

  • Literature review of original articles.
  • Searches conducted in PubMed, Elsevier, and Tompson ISI Web of Knowledge databases.
  • Focus on studies examining CNI use in pediatric organ transplantation and associated nephropathy.

Main Results:

  • Clinical evidence confirms the occurrence of CNI-related nephrotoxicity.
  • The prevalence and seriousness of chronic CNI nephrotoxicity are debated due to nonspecific pathological lesions.
  • Research efforts are directed towards early detection markers and preventative/management strategies for CNI nephrotoxicity.

Conclusions:

  • CNI-mediated nephrotoxicity warrants serious clinical consideration.
  • Future research should prioritize early detection markers for CNI nephrotoxicity.
  • Developing improved immunosuppressive therapies and alternative treatments is crucial.
Abstract

Keywords:
Calcineurin inhibitors (CNIs)ChildrenNephrotic syndromeNephrotoxicityTransplantation

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