2013
DOI: 10.4103/0971-4065.107197
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Calcineurin inhibitor induced nephrotoxicity in steroid resistant nephrotic syndrome

Abstract: Prolonged therapy with calcineurin inhibitors (CNI) is effective in patients with difficult nephrotic syndrome. However, information on prevalence and risk factors for nephrotoxicity in children with steroid-resistant nephrotic syndrome is limited. This retrospective observational study was conducted on 40 patients with steroid-resistant nephrotic syndrome treated with cyclosporine (CyA) (n = 28) or tacrolimus (n = 12) for more than 2 years. Nephrotoxicity was defined by the presence of striped fibrosis involv… Show more

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Cited by 31 publications
(7 citation statements)
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“…Tacrolimus binds to FKBP12 protein, blocking the catalytic site of calcineurin, thus inhibiting the activation of the NFAT and Crz1 transcription factors. However, the use of FK506 blocks calcineurin activity, which is proved to play crucial roles especially in neurological and nephrotic tissues [ 52 , 53 ]. Thus, it is essential to elucidate the mechanisms by which 11β,13-dihydrolactucin modulates Crz1/NFAT activity.…”
Section: Discussionmentioning
confidence: 99%
“…Tacrolimus binds to FKBP12 protein, blocking the catalytic site of calcineurin, thus inhibiting the activation of the NFAT and Crz1 transcription factors. However, the use of FK506 blocks calcineurin activity, which is proved to play crucial roles especially in neurological and nephrotic tissues [ 52 , 53 ]. Thus, it is essential to elucidate the mechanisms by which 11β,13-dihydrolactucin modulates Crz1/NFAT activity.…”
Section: Discussionmentioning
confidence: 99%
“…In a retrospective study, there was no significant association between TAC exposure and biopsy changes although the average trough level was higher in those children with worsening histological findings. [ 22 23 24 ]…”
Section: Discussionmentioning
confidence: 99%
“…Concerns exist regarding chronic nephrotoxicity with the use of long-term CNI. Continuation of CNIs for more than 2 to 5 years has been shown to be associated with renal toxicity [ 32 , 35 , 36 ]. In patients with steroid-dependent nephrotic syndrome (SDNS), chronic histologic lesions due to CNI use were reported in as high as 35–75% of patients on renal biopsy [ 37 40 ].…”
Section: Intensified Immunosuppression and Adjuvant Agents For Srnsmentioning
confidence: 99%