ArticleClinical journal of the American Society of Nephrology : CJASN2009
Risk factors for cyclosporin A nephrotoxicity in children with steroid-dependant nephrotic syndrome.
Article in Clinical journal of the American Society of Nephrology : CJASN, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 59 citations in OpenAlex.
- IPNA clinical practice recommendations for the diagnosis and management of children with steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2020Guideline
- Clinical practice guideline for pediatric idiopathic nephrotic syndrome 2013: medical therapy.Clinical and experimental nephrology · 2015Guideline
- Serum suPAR levels are modulated by immunosuppressive therapy of minimal change nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2014Trial
- Cyclosporine C2 monitoring for the treatment of frequently relapsing nephrotic syndrome in children: a multicenter randomized phase II trial.Clinical journal of the American Society of Nephrology : CJASN · 2014Trial
- Mycophenolate mofetil versus cyclosporin A in children with frequently relapsing nephrotic syndrome.Journal of the American Society of Nephrology : JASN · 2013Trial
- Mycophenolate mofetil for steroid-dependent nephrotic syndrome: a phase II Bayesian trial.Pediatric nephrology (Berlin, Germany) · 2012Trial
- Cyclosporine A treatment in patients with Alport syndrome: a single-center experience.Pediatric nephrology (Berlin, Germany) · 2010Trial
- Mechanisms of Podocyte Injury in Kidney Allografts.Kidney360 · 2026Review
- Corticosteroids augment cyclosporine nephrotoxicity in pediatric nephrotic syndrome: potential role of alternatively activated macrophages.Pediatric nephrology (Berlin, Germany) · 2026Article
- Factors associated with chronic calcineurin inhibitor nephrotoxicity in children with minimal-change disease.Renal failure · 2025Article
- Prolonged remission after cyclophosphamide or tacrolimus treatment in childhood nephrotic syndrome: a cohort study.Pediatric nephrology (Berlin, Germany) · 2025Article
- Adult survivors of childhood-onset steroid-dependent and steroid-resistant nephrotic syndrome treated with cyclosporine: a long-term single-center experience.Pediatric nephrology (Berlin, Germany) · 2024Article
- Cyclosporine A CClinical and experimental nephrology · 2022Article
- Podocytopathies.Nature reviews. Disease primers · 2020Review
- Infrequent tacrolimus-induced nephrotoxicity in French patients with steroid-dependent nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2019Observational
- Treating the idiopathic nephrotic syndrome: are steroids the answer?Pediatric nephrology (Berlin, Germany) · 2019Review
- Is medium dose of cyclosporine A effective in treatment of children with steroid-dependent nephrotic syndrome with reduction in corticosteroids dose consumption?Clinical and experimental nephrology · 2019Article
- Effectiveness and nephrotoxicity of a 2-year medium dose of cyclosporine in pediatric patients with steroid-dependent nephrotic syndrome: determination of the need for follow-up kidney biopsy.Clinical and experimental nephrology · 2018Article
- Nephrotoxicity in children with frequently relapsing nephrotic syndrome receiving long-term cyclosporine treatment.Pediatric nephrology (Berlin, Germany) · 2017Article
- High incidence of idiopathic nephrotic syndrome in East Asian children: a nationwide survey in Japan (JP-SHINE study).Clinical and experimental nephrology · 2017Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesCyclosporin A (CsA) is a well-established treatment for steroid-dependent nephrotic syndrome (SDNS) that may, however, cause chronic ischemic renal lesions. The objective of the study was to assess the prevalence of CsA nephrotoxicity (CsAN) in protocol biopsies of children with SDNS. DESIGN, SETTINGS, PARTICIPANTS, & MEASUREMENTS: From 1990 through 2008, we performed 71 renal biopsies in 53 patients with SDNS. The mean CsA C2 levels were 466 +/- 134 ng/ml, and the mean duration of treatment was 4.7 +/- 2.0 yr before biopsy (range 2.9 to 12.7 yr).
resultsCsAN was observed in 22 (31%) of 71 renal biopsies. Of these, 11 corresponded to isolated vascular or tubular lesions, and 11 corresponded to combined vascular and tubular lesions. The majority of CsAN lesions were mild (17 of 22). In no cases were lesions graded as severe. By regression analysis, CsAN was positively associated with the use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and with hyperuricemia and negatively associated with minimal-change lesions. By multivariate analysis, only association with the use of ACEIs or ARBs retained significance. Stratification of the population according to CsA C2 levels showed increased risk for CsAN for C2 levels >600 ng/ml.
conclusionsMild to moderate CsAN occurs in approximately one third of patients who have SDNS and are treated with CsA for >3 yr. Our data suggest that patients who require high dosages of CsA or treatment for hypertension, in particular when ACEIs/ARBs are used, are at higher risk for CsAN.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.