Acute and chronic nephrotoxicity associated with immunosuppressive drugs

Although the main immunosuppressive drugs used commonly after transplantation and in the treatment of autoimmune disease are cyclosporine and FK506, both have similar nephrotoxic properties that may limit their clinical use. The complexity of both the functional and structural characteristics of cyclosporine and FK506 nephrotoxicity strongly suggests a multifactorial process involving complex physiologic and intracellular signaling processes that have obvious implications for the design and development of new immunosuppressive drugs. This review summarizes recent concepts regarding the mechanisms responsible for the renal dysfunction related to these drugs and outlines methods of possible therapeutic intervention.