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Clinical evaluation of chronic nephrotoxicity of long-term cyclosporine A treatment in adult patients with steroid-dependent nephrotic syndrome.
MedLine Citation:
PMID:  21077987     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Aim:  Chronic nephrotoxicity of long-term cyclosporine A (CsA) treatment is a matter of concern in patients with steroid-dependent nephrotic syndrome (SDNS). Methods:  Twenty-eight adult NS patients (25, minimal-change nephrotic syndrome (NS); three, focal-segmental glomerulosclerosis) were divided into three groups. Group A was continuously treated with CsA for more than 5 years (143 ± 40 months, 1.3 ± 0.4 mg/kg per day at final analysis, n = 12); group B had been previously treated with CsA (70 ± 27 months, n = 6); and group C had been treated with corticosteroids alone (n = 10). The clinical variables related to chronic CsA nephrotoxicity were examined. Results:  In groups A and B, estimated glomerular filtration rate decreased from 86 ± 22 and 107 ± 17 to 83 ± 23 and 88 ± 13 mL/min per 1.73 m(2) , respectively, at final analysis (both P < 0.05). Serum magnesium levels in group A were significantly lower than those in group B or C (A, 1.78 ± 0.16 mg/dL; B, 2.00 ± 0.14 mg/dL; C, 2.03 ± 0.10 mg/dL; A vs B, C, P < 0.01), and a significant correlation between these and the duration of CsA treatment was found (r = -0.68, P < 0.001). There was a trend towards a correlation between the duration of CsA administration and urinary α1-microglobulin (r = 0.38, P = 0.07). Conclusion:  Mild decrease in renal function and hypomagnesemia were found in adult SDNS patients with long-term CsA treatment. Careful monitoring of renal function, blood pressure and serum magnesium levels is necessary.
Authors:
Tomonari Okada; Hiroshi Matsumoto; Yume Nagaoka; Ryo Tomaru; Hideaki Iwasawa; Toshikazu Wada; Toshiyuki Nakao
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  16     ISSN:  1440-1797     ISO Abbreviation:  Nephrology (Carlton)     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  319-25     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology.
Affiliation:
Department of Nephrology, Tokyo Medical University, Tokyo, Japan.
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