ArticlePediatric nephrology (Berlin, Germany)2017
Nephrotoxicity in children with frequently relapsing nephrotic syndrome receiving long-term cyclosporine treatment.
Article in Pediatric nephrology (Berlin, Germany), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 24 citations in OpenAlex.
- Predictive value of CD44 in membranous nephropathy with focal segmental glomerular sclerosis lesions treated with calcineurin inhibitors.Renal failure · 2026Article
- Corticosteroids augment cyclosporine nephrotoxicity in pediatric nephrotic syndrome: potential role of alternatively activated macrophages.Pediatric nephrology (Berlin, Germany) · 2026Article
- Review
- The Role of Cyclosporine in the Treatment of Severe Ulcerative Colitis in the Pediatric Population: A Narrative Review Exploring Known Strategies and New Possibilities.Journal of clinical medicine · 2025Review
- Treatment-Associated Side Effects in Patients with Steroid-Dependent Nephrotic Syndrome.Maedica · 2022Article
- Review
- Current understandings in treating children with steroid-resistant nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2021Review
- Rhabdomyosarcoma in a child with nephrotic syndrome treated with cyclosporine: a case report with literature review.BMC nephrology · 2020Review
- Effective improvement of minimal change nephrotic syndrome with uncontrollable high low-density lipoprotein cholesterol level using evolocumab accompanied by the development of acute pancreatitis.CEN case reports · 2020Article
- Infrequent tacrolimus-induced nephrotoxicity in French patients with steroid-dependent nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2019Observational
- Impact of interrupted cyclosporine treatment on the development of chronic nephrotoxicity in children with steroid-dependent nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2017Article
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9 authors at 4 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundSteroid-sparing drugs, such as cyclosporine, are recommended as treatment for children with frequently relapsing nephrotic syndrome (FRNS) and steroid-related toxicities. We recently reported a high rate of relapsing nephrotic syndrome 2 years after discontinuation of cyclosporine treatment, suggesting that long-term treatment is necessary. Cyclosporine-associated nephrotoxicity (CAN) is a potential side effect of long-term cyclosporine treatment.
methodsWe retrospectively reviewed pediatric patients with FRNS treated with cyclosporine for ≥3 years at a single center between 1999 and 2012. The cyclosporine dose was adjusted to maintain the whole-blood cyclosporine trough level at 80-100 ng/ml for 6 months, at 60-80 ng/ml for 18 months, and then at around 50-60 ng/ml thereafter. Maintenance dose of prednisolone was not prescribed. CAN was graded in terms of arteriolar hyalinosis and the degree of interstitial fibrosis.
resultsThirty-six children (28 males) were enrolled in the study. The median age at the start of long-term cyclosporine treatment was 9.4 years. The median duration of the longest period of cyclosporine treatment was 4.5 years. Most CAN cases were characterized by arteriolar hyalinosis. The frequency of CAN was positively correlated with the duration of cyclosporine treatment, with an odds ratio (95% confidence interval) for CAN of 3.84 (0.79-18.74) after 2-5 years and 6.60 (1.18-36.94) after >5 years of cyclosporine treatment (vs. 0-2 years).
conclusionsAlthough the frequency of CAN was correlated with the duration of cyclosporine treatment in our pediatric patient population, most cases of CAN involved arteriolar hyalinosis. We conclude that long-term cyclosporine treatment is useful for treating FRNS in children, providing its dose is controlled and kidney biopsies are regularly performed.
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