Related Experiment Videos
Renal function in patients receiving long-term cyclosporine therapy
D H Van Buren1, J F Burke, R M Lewis
1Renal Transplantation Division, Vanderbilt University Medical Center, Nashville, TN 37232-4750.
Journal of the American Society of Nephrology : JASN
|February 1, 1994
Summary
Cyclosporine can cause acute kidney injury by affecting the afferent arteriole. However, long-term kidney transplant function decline is primarily due to immunologic injury, not cyclosporine toxicity.
Area of Science:
- Nephrology
- Immunology
- Pharmacology
Background:
- Cyclosporine is an immunosuppressant drug used in organ transplantation.
- Acute nephrotoxicity is a known side effect of cyclosporine, potentially mediated by vasoconstriction.
- The role of cyclosporine in chronic progressive renal allograft dysfunction remains debated.
Framework:
- Investigating the mechanisms of cyclosporine-induced vasoconstriction.
- Analyzing the relationship between vasoconstriction and chronic allograft dysfunction.
- Evaluating the long-term impact of cyclosporine on renal allograft function.
Implementation:
- Examining proposed mechanisms: sympathetic nerve stimulation, prostaglandin imbalance, hypersensitivity to vasoactive peptides, and endothelin release.
- Reviewing histologic findings in chronic progressive renal dysfunction.
- Analyzing retrospective and prospective studies with serial renal function markers (serum creatinine, GFR).
Implications:
- Cyclosporine-associated intrarenal vasoconstriction may contribute to acute kidney injury.
- Chronic allograft dysfunction appears predominantly driven by immunologic injury rather than direct cyclosporine toxicity.
- Renal function in transplant recipients stabilizes after an initial period, with no excessive progression to end-stage renal disease (ESRD).