Reasonable application of cyclosporin A in renal diseases

doi:10.3877/cma.j.issn.2095-3216.2014.04.005

Abstract

Abstract:

Cyclosporine is a widely-used efficient immunosuppressant in organ transplantation, but its efficacy and side effects in the relevant applications of kidney diseases are not completely clear. This paper has summarized the clinical studies on cyclosporine A in treatment of a variety of kidney diseases,including its indications, dosage, course of treatment, curative effect, and adverse reactions. Also discussed are how to give full play to its effectiveness and how to avoid its side effects so as to achieve the objective of reasonable clinical use of it.

Key words: Cyclosporine A, Kidney diseases

Junming Fan, Ji Wen, Qiongdan Hu. Reasonable application of cyclosporin A in renal diseases[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2014, 03(04): 193-199.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsbyjdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-3216.2014.04.005

https://zhsbyjdzzz.cma-cmc.com.cn/EN/Y2014/V03/I04/193

References 69

1	International Study of Kidney Disease. Minimal change nephritic syndrome in children: deaths during the first 5 to 15 years 'observation. Report of the International Study of Kidney Disease in Children [J]. Pediatrics,1984,73(4):497-501.
2	Nolasco F, Cameron JS, Heywood EF, et al. Adult-onset nephritic syndrome: a long-term follow-up [J]. Kidney Int, 1986, 29(6):1215-1223.
3	Matsumoto H, Nakao T, Okada T, et al. Favorable outcome of low dose cyclosporine after pulse methylprednisolone in Japanese adult minimal-change nephritic syndrome [J]. Intern Med, 2004, 43(8):668-673.
4	Eguchi A, Takei T, Yoshida T, et al. Combined cyclosporine and prednisolone therapy in adult patients with the first relapse of minimal-change nephrotic syndrome [J]. Nephrol Dial Transplant,2010,25(1):124-129.
5	Chan MK, Cheng IK. Cyclosporine A in steroid sensitive nephrotic syndrome with frequent Relapses [J]. Postgrad Med J, 1987, 63(743):757-759.
6	Clasen W, Kindler J, Mihatsch MJ, et al. Long-term treatment of minimal change nephrotic syndrome with cyclosporine: a control biopsy study[J]. Nephrol Dial Transplant,1988,3(6):733-777.
7	Ghiggeri GM, Catarsi P, Scolari F, et al. Cyclosporine in patients with steroid-resistant nephrotic syndrome: an open-label,nonrandomized, retrospective study [J]. Clin Ther,2004,26(9):1411-1418.
8	Cattran DC, Appel GB, Hebert LA, et al. A randomized trial of cyclosporine in patients with steroid-resistant focal segmental glomerulosclerosis[J]. Kidney Int,1999,56(6):2220-2226.
9	Gipson DS, Trachtman H, Kaskel FJ, et al. Clinical trial of focal segmental glomerulosclerosis in children and young adults [J].Kidney Int,2011,80(8):868-878.
10	Heering P, Braun N, Mullejans R, et al. Cyclosporine A and chlorambucil in the treatment of idiopathic focal segmental glomerulosclerosis [J]. Am J Kidney Dis,2004,43(1):10-18.
11	Segarra Medrano A, Vila Presas J, Pou Clavé L, et al. Efficacy and safety of combined cyclosporin A and mycophenolate mofetil therapy inpatientswithcyclosporin-resistantfocalsegmental glomerulosclerosis [J]. Nefrologia,2011,31(3):286-291.
12	Hogg RJ, Friedman A, Greene T, et al. Renal function and proteinuria after successful immunosuppressive therapies in patients with FSGS [J]. Clin J Am Soc Nephrol,2013,8(2):211-2118.
13	Cameron JS, Healy MJ, Adu D. The Medical Research Council trial of short-term high-dose alternate day prednisolone in idiopathic membranous nephropathy with nephrotic syndrome in adults [J]. Q J Med,1990,74(274):133-156.
14	Cattran DC, Delmore T, Roscoe J, et al. A randomized controlled trial of prednisone in patients with idiopathic membranous nephropathy [J]. N Engl J Med,1989,320(4):210-215.
15	Eriguchi M, Oka H, Mizobuchi T, et al. Long-term outcomes of idiopathic membranous nephropathy in Japanese patients treated with low-dose cyclophosphamide and prednisolone [J]. Nephrol Dial Transplant,2009,24(10):3082-3088.
16	Shiiki H, Saito T, Nishitani Y, et al. Prognosis and risk factors for idiopathic membranous nephropathy with nephrotic syndrome in Japan [J]. Kidney Int,2004,65(4):1400-1407.
17	葛晓,王艳丽,杨莉娅,等.环孢素A 治疗特发性膜性肾病的荟萃分析[J].临床荟萃,2012,27(3):196-201
18	Cattran DC, Appel GB, Hebert LA, et al. Cyclosporine in patients with steroid-resistant membranous nephropathy: a randomized trial[J]. Kidney Int,2001,59(4):1484-1490.
19	Cattran DC, Greenwood C, Ritchie S, et al. A controlled trial of cyclosporine in patients with progressive membranous nephropathy[J]. Kidney Int,1995,47(4):1130-1135.
20	Alexopoulos E, Papagianni A, Tsamelashvili M, et al. Induction and long-term treatment with cyclosporine in membranous nephropathy with the nephrotic syndrome [ J]. Nephrol Dial Transplant,2006,21(11):3127-3132.
21	Shin DH, Lee MJ, Oh HJ, et al. Stepwise treatment using corticosteroids alone and incombination with cyclosporine in Korean patients with idiopathic membranous nephropathy [J]. Yonsei Med J,2013,54(4):973-982.
22	Goumenos DS, Katopodis KP, Passadakis P, et al. Corticosteroids and cyclosporin A in idiopathic membraneous nephropathy: higher remission rates of nephrotic syndrome and less adverse reactions than after traditional treatment with cytotoxic drugs [J]. Am J Nephrol,2007,27(3):226-231.
23	Fritsche L, Budde K, Farber L, et al. Treatment of membranous glomerulonephropathy with cyclosporin A: how much patience is required [J]? Nephrol Dial Transplant,1999,14(4):1036-1038.
24	Ambalavanan S, Fauvel JP, Sibley RK, et al. Mechanism of the antiproteinuric effect of cyclosporine in membranous nephropathy[J]. J Am Soc Nephrol,1996,7(2):290-298.
25	Rostoker G, Belghiti D, Ben Maadi A, et al. Long-term cyclosporin A therapy for severe idiopathic membranous nephropathy [J].Nephron,1993,63(3):335-361.
26	Saito T, Iwano M, Matsumoto K, et al. Significance of combined cyclosporine-prednisolone therapyandcyclosporineblood concentration monitoring for idiopathic membranous nephropathy with steroid-resistant nephrotic syndrome: a randomized controlled multicenter trial [J]. Clin Exp Nephrol, 2013, [Epub ahead of print].
27	Cattran DC, Alexopoulos E, Heering P, et al. Cyclosporin in idiopathic glomerular disease associated with the nephrotic syndrome:workshop recommendations [J]. Kidney Int,2007,72(12): 1429-1447.
28	Lai KN, Lai FM, Li PK, et al. Cyclosporin treatment of IgA nephropathy: a short term controlled trial [J]. Br Med J, 1987,295(6607):1165-1168.
29	Chabova V, Tesar V, Zabka J, et al. Long-term treatment of IgA nephropathy with cyclosporin A-a preliminary report [J]. Nephrol Dial Transplant,1997,12(10):2206-2207.
30	Shin JI, Lim BJ, Kim PK, et al. Effects of cyclosporin A therapy combined with steroids and angiotensin converting enzyme inhibitors on childhood IgA nephropathy [J]. J Korean Med Sci, 2010, 25(5):723-727.
31	Liu H, Xu X, Fang Y, et al. Comparison of glucocorticoids alone and combined with cyclosporine a in patients with IgA nephropathy:a prospective randomized controlled trial[J]. Intern Med,2014,53(7):675-681.
32	Lim BJ, Kim JH, Hong SW, et al. Expression of fibrosis-associated molecules in IgA nephropathy treated with cyclosporine [J]. Pediatr Nephrol,2009,24(3):513-519.
33	Kidney Disease: Improving Global Outcomes ( KDIGO )Glomerulonephritis Work Group. KDIGO Clinical Practice Guideline for Glomerulonephritis [J]. Kidney Int Suppl, 2012, 2(2): 139-274.
34	Someya T, Kaneko K, Fujinaga S, et al. Cyclosporine A for heavy proteinuria in a child with Henoch-Schönlein purpura nephritis [J].Pediatr Int,2004,46(1):111-113.
35	Shin JI, Park JM, Shin YH, et al. Cyclosporin A therapy for severe Henoch-Schönlein nephritis with nephrotic syndrome [J]. Pediatr Nephrol,2005,20(8):1093-1097.
36	Shin JI, Park JM, Shin YH, et al. Henoch-Schönlein purpura nephritis with nephrotic-range proteinuria: histological regression possibly associated with cyclosporin A and steroid treatment [J].Scand J Rheumatol,2005,34(5):392-395.
37	Ronkainen J, Autio-Harmainen H, Nuutinen M. Cyclosporin A for the treatment of severe Henoch-Schönlein glomerulonephritis [J].Pediatr Nephrol,2003,18(11):1138-1142.
38	Jee MP,Sung CW,Jae IS,et al. Cyclosporin A therapy for Henoch-Schönlein nephritis with nephrotic-range proteinuria [J]. Pediatr Nephrol,2011,26 (3):411-417.
39	Jauhola O,Ronkainen J,Autio-Harmainen H,et al. Cyclosporine A vs. methylprednisolone for Henoch-Schönlein nephritis: a randomized trial [J]. Pediatr Nephrol, 2011, 26(12): 2159-2166.
40	Ohara S,Kawasaki Y,Miyazaki K, et al. Efficacy of cyclosporine A for steroid-resistant severe Henoch-Schönlein purpura nephritis.Fukushima J Med Sci,2013,59(2):102-107.
41	中华医学会儿科学分会肾脏病学组. 儿童常见肾脏疾病诊治循证指南(二):紫癜性肾炎的诊治循证指南(试行)[J].中华儿科杂志,2009,47(12):911-913.
42	Isenberg DA, Snaith ML, Morrow WJ, et al. Cyclosporin A for the treatment of systemic lupus erythematosus [ J ]. Int J Immunopharmacol,1981,3(2):163-169.
43	Favre H, Miescher PA, Huang YP, et al. Cyclosporin in the treatment of lupus nephritis [J]. Am J Nephrol,1989,9(Suppl):57-60.
44	Kamijo Y, Hashimoto K, Takahashi K, et al. Treatment with cyclosporine A improves SLE disease activity of Japanese patients with diffuse proliferative lupus nephritis [J]. Clin Nephrol, 2011,76(2):136-143.
45	Kawasaki Y, Hosoya M, Takano K, et al. Efficacy of cyclosporine therapy for systemic lupus erythematosus in childhood [J]. Pediatr Int,2008,50(2):257-259.
46	Suzuki K, Tanaka H, Tsugawa K, et al. Effective treatment with cyclosporine A of a child with systemic lupus erythematosus resistant to cyclophosphamide pulse therapy [J]. Tohoku J Exp Med,2006,208(4):355-359.
47	Tam LS, Li EK, Szeto CC, et al. Treatment of membranous lupus nephritis with prednisone, azathioprine and cyclosporin A [J].Lupus,2001,10(11):827-829.
48	Hu W, Liu Z, Shen S, et al. Cyclosporine A in treatment of membranous lupus nephropathy [J]. Chin Med J,2003,116(12):1827-1830.
49	Austin HA III, Illei GG, Braun MJ, et al. Randomized, controlled trial of prednisone, cyclophosphamide, and cyclosporine in lupus membranous nephropathy [J]. J Am Soc Nephrol, 2009, 20(4):901-911.
50	Zavada J, Pesickova S, Rysava R, et al. Cyclosporine A or intravenous cyclophosphamide for lupus nephritis: the Cyclofa-Lune study [J]. Lupus,2010,19(11):1281-1289.
51	Moroni G, Doria A, Mosca M, et al. A randomized pilot trial comparing cyclosporine versus azathioprine for maintenance therapy in diffuse lupus nephritis over four years [J]. Clin J Am Soc Nephrol,2006,1(5):925-932.
52	Tam LS, Li EK, Leung CB, et al. Long-term treatment of lupus nephritis with cyclosporin A [J]. Q J Med, 1998, 91(8): 573-580.
53	Ogawa H, Kameda H, Nagasawa H, et al. Prospective study of low dose cyclosporine A in patients with refractory lupus nephritis [J].Mod Rheumatol,2007,17(2):92-97.
54	Dostál C, Tesar V, Rychlík I, et al. Effect of 1 year cyclosporine A treatment on the activity and renal involvement of systemic lupus erythematosus: a pilot study[J]. Lupus,1998,7(1):29-36.
55	Rihova Z, Vankova Z, Maixnerova D, et al. Treatment of lupus nephritis with cyclosporine-an outcome analysis [J]. Kidney Blood Press Res,2007,30(2):124-128.
56	Fu LW, Yang LY, Chen WP, et al. Clinical efficacy of cyclosporin A Neoral in the treatment of paediatric lupus nephritis with heavy proteinuria [J]. Br J Rheumatol,1998,37(2):217-221.
57	Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association ( EULAR/ERAEDTA) recommendations for the management of adult and paediatric lupus nephritis [J]. Ann Rheum Dis,2012,71(11):1771-1782.
58	李芹,赵秀杰,唐绍芬,等. 环孢素A 人体药动学影响因素分析[J].中国医院药学杂志,2002,2-2(7):431.
59	Oellerich M, Armstrong VW. Two-hour cyclosporine concentration determination: an appropriate tool to monitor neural therapy [J].Ther Drug Monit,2002,24(1):40-46.
60	Johnston A, Chusney G, Schǜtz E, et al. Monitoring cyclosporin in blood: between-assay differences at trough and 2 hours post-dose(C2) [J]. Ther Drug Monit,2003,25(2):167-173.
61	Keown PA. New concepts in cyclosporine monitoring[J]. Curr Opin Nephrol Hypertens,2002,11(6):619-629.
62	邵丽佳,徐瑞龙,朱以军,等. 肾移植患者口服环孢素A 的血药浓度监测分析. 中国现代应用药学杂志,2007,24(3):247.
63	Camara NO, Matos AC, Rodrigues DA, et al. Early detection of heart transplant patients with increased risk of cyclosporin nephrotoxicity [J]. Lancet,2001,357(9259):856-857.
64	Kahan BD. Therapeutic drug monitoring of cyclosporine:20 years of progress. Transplant Proc,2004,36(2 Suppl):378S-391S.
65	万元胜,师少军,吴伶,等. 环孢素A 血药浓度影响因素综述[J].西部流行病学杂志,2006,15(3):152-154.
66	Dawidson I, Rooth P, Alway C, et al. Verapamil prevents posttransplant delayed function and cyclosporine A nephrotoxicity[J]. Transplant Proc,1990,22(4):1379-1380.
67	Kessler M, Netter P, Renoult E, et al. Influence of nicardipine on renal function and plasma cyclosporin in renal transplant patients[J]. Eur J Clin Pharmacol,1989,36(6):637-638.
68	Ichikawa I. Will angiotensin Ⅱ receptor antagonists be renoprotective in humans [J]? Kidney Int, 1996, 50(2): 684-692.
69	Burdmann EA, Andoh TF, Nast CC, et al. Prevention of experimental cyclosporin-induced interstitial fibrosis by losartan and enalapril [J]. Am J Physiol,1995,269(4 Pt 2): F491-F499.

[1]	. [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2015, 12(1): 72-80.
[2]	Pei Qian, Ying Bao, Ying Yang, Lei Suo, Huimei Huang. Clinical analysis of nephronophthisis caused by compound heterozygous variants of NPHP1 gene [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2022, 18(03): 330-336.
[3]	Jinyi Wang, Tingyi Bao. Predictive values of serum uric acid and NLRP3 inflammasome in pregnant women with hypertensive disorder complicating pregnancy with acute kidney injury [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2021, 17(06): 663-670.
[4]	Hui Shang, Yuhong Tao. Protection effects of vitamin D and its analogues on children with pediatric kidney diseases [J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2021, 17(05): 497-502.
[5]	Yong Zhang, Wei Zhang, Jianping Zhang, Wenli Zhuo, Weizhen Wu, Jianming Tan. Effect of mesenchymal stem cells on transforming growth factor-β1 in renal tissue of chronic cyclosporine nephropathy in rats [J]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2017, 07(01): 18-22.
[6]	Xiayu Ren, Yanjuan Hou, Lihua Wang. Research progress on the role of sphingosine-1-phosphate in kidney diseases [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(06): 344-348.
[7]	Delun Li, Siyu Yuan, Anqi Liu. Progress of research on the role of microRNA-155 in renal diseases [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(01): 39-43.
[8]	Wanjun Shen, Tiantian Wang, Zhiwei Yin, Yuansheng Xie. Application of immunoelectron microscopy in diagnosis and research of renal diseases [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2022, 11(04): 219-223.
[9]	Denghu Yao, Guohua Ding. Definition, stage, and epidemiology of acute kidney disease [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2017, 06(06): 246-251.
[10]	Jianchun Zhang, Shaohua Wang, Yuanyuan Li, Yunlai Liu, Yinan Ma, Wenzhi Chen, Youkang Zhang. Clinical features and genetic diagnosis of autosomal dominant tubulointerstitial kidney diseases (ADTKD)-hepatocyte nuclear factor 1β (HNF1β) [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2017, 06(01): 20-24.
[11]	Yubao Chen, Pengcheng Yan. Bioinformatics analysis and its applications in kidney disease studies [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2017, 06(01): 14-19.
[12]	Jia Chen, Yani He. Progress of research on TRAIL and its receptors in kidney diseases [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2015, 04(04): 208-211.
[13]	Yani He, Jia Chen. Application status of rapamycin in renal diseases [J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2014, 03(04): 183-187.
[14]	Xu Zhuang, Li Ding, Li Xu, Ning Zhang, Yu Zhang, Jianhua Lin. Study on the relationship between abnormal renal ultrasound image and adverse pregnant outcomes in pregnancies with chronic kidney disease [J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2024, 13(02): 100-105.
[15]	Lei Wang, Wenli Sun, Jiaqi Chen, Hongxing Liu. Research progress on laboratory monitoring cyclosporine A concentration in the whole blood [J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2019, 07(02): 65-70.

Please choose a citation manager

Content to export