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Effect of cyclosporin a on proteinuria in patients with Alport's syndrome

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Abstract

Eight patients with Alport's syndrome and massive proteinuria (129±60.57 mg/m2 per hour) were treated with cyclosporin A (CyA) for 8 months. The average dose of CyA administered to all patients was 4.21±0.26 mg/kg per day and blood CyA levels of 63.4±4.1 ng/ml were attained. In five patients, proteinuria abated during the 3rd week of treatment. In the remaining three, all of whom had low creatinine clearance (82.0, 46.0 and 43.2 ml/min per 1.73 m2 respectively), proteinuria persisted but at levels lower than before treatment: 32.5±15.9 mg/m2 per hour versus 183.3±29.7 mg/m2 per hour. No permanent decrease in creatinine clearance was observed in any of these patients throughout treatment. In those patients in whom proteinuria abated, it reappeared 2 weeks after discontinuation of CyA treatment. We observed no significant increases in angiotensin II plasma levels in our patients during CyA administration. Although we have shown that CyA will reduce massive proteinuria in patients with Alport's syndrome, we cannot yet recommend its use as a therapeutic measure.

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References

  1. Callis L (1983) Alport's syndrome. Proceedings of the 17th International Congress of Pediatrics, Manila, vol 2. pp 21–22

    Google Scholar 

  2. Abarca A, Alarcon A, Alsina J (1988) The use of ciclosporin in glomerulonephritis. Data of 61 patients in the Cooperative study of the Spanish Society of Nephrology. Neforlogia 1 [Suppl 1]: 15–23

    Google Scholar 

  3. Brandis M, Burghard R, Leititis J, Zimerhackl B, Hilbrandt F, Helmchen U (1987) Cyclosporin A for treatment in nephrotic syndrome. Pediatr Nephrol 1: C42

    Google Scholar 

  4. Hoyer PF, Krull F, Brodhel J (1986) Cyclosporin in frequently relapsing minimal change nephrotic syndrome (letter). Lancet II: 335

    Google Scholar 

  5. Niaudet P, Habib R, Tete MJ, Hinglais N, Broyer M (1987) Cyclosporin in the treatment of idiopathic nephrotic syndrome in children. Pediatr Nephrol 1: 566–573

    Google Scholar 

  6. Tejani A, Butt K, Khawar R, Sthabthuran M, Rosenthal CJ, Tachtman H, Fusi M (1985) Cyclosporin(CY) induced remission of relapsing nephrotic syndrome (RNC) in children. Kidney Int 29: 206

    Google Scholar 

  7. Vela M, Egido J, Lozano L (1988) Treatment of glomerular disease with cyclosporin A. Nefrologia 8 [Suppl 1]: 9–14

    Google Scholar 

  8. Mimram A, Mourad J, Ribstein J (1990) The renin-angiotensin system and renal function in kidney transplantation. Kidney Int 38: [Suppl 30]: S114-S117

    Google Scholar 

  9. Murray BM, Paller MS, Ferris TF (1985) Effect of cyclosporine administration on renal hemodynamics in conscious rats. Kidney Int 28: 767–774

    Google Scholar 

  10. Perico N, Benigni A, Bosco E, Rossini M, Orisio S, Ghilardi F, Piccinelli A, Remussi G (1986) Acute cyclosporine A nephrotoxicity in rats. Which role for renin-angiotensin system and glomerular prostaglandins? Clin Nephrol 25: 583–588

    Google Scholar 

  11. Antonovych TT, Deasy PF, Tina LU, Albora JB d', Holerman CE, Cacagno PL (1969) Hereditary nephritis: early clinical, functional and morphological studies. Pediatr Res 3: 545–550

    Google Scholar 

  12. Gubier M, Levy M, Broyer M, Naizot C, Gonzalez G, Perrin D, Habib R (1981) Alport's syndrome, a report of 58 cases and a review of the literature. Am J Med 70: 493–505

    Google Scholar 

  13. Bernstein J, Kissane JM (1978) Hereditary nephritis. In: Edelmann CM Jr (ed) Pediatric kidney disease. Little Brown, Boston, pp 571–580

    Google Scholar 

  14. Spear GS, Slusser RJ (1972) Alport's syndrome. Am J Med 69: 213–223

    Google Scholar 

  15. A report of the International Study of Kidney Disease in Children (1978) Nephrotic syndrome in children: prediction of histopathology from clinical and laboratory characteristics at time of diagnosis. Kidney Int 13: 159–165

    Google Scholar 

  16. Al-Muzairai IA, Innes A, Hillis A, Stewart KN, Bone JM, Catto GRD, MacLead A (1989) Renal transplantation: cyclosporin A and antibody development after donor-specific transfusion. Kidney Int 35: 1057–1063

    Google Scholar 

  17. Salomon DR, Pickard LL (1987) Cyclosporine permits suppressor T cell induction but inhibits an amplification circuit dependent on IL2 and a suppressor-inducer lymphokine (SIL) (abstract). Kidney Int 31: 468

    Google Scholar 

  18. Jackson NM, Convery ME, Humes HD (1987) Cyclosporine-induced cell proliferation is unique to the kidney (abstract). Kidney Int 31: 468

    Google Scholar 

  19. Ter Borg EJ, Tegzess AM, Kallenberg OG (1988) Unexpected severe reversible cyclosporine A induced nephrotoxicity in a patient with systemic lupus erythematosus and tubulointerstitial renal disease. Clin Nephrol 29: 93–95

    Google Scholar 

  20. Mihatsch MJ, Steiner K, Abeywickrama KH, Landmann J, Thiel G (1988) Risk factors for the development of chronic cyclosporine-nephrotoxicity. Clin Nephrol 29: 165–175

    Google Scholar 

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Callís, L., Vila, A., Nieto, J. et al. Effect of cyclosporin a on proteinuria in patients with Alport's syndrome. Pediatr Nephrol 6, 140–144 (1992). https://doi.org/10.1007/BF00866293

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  • DOI: https://doi.org/10.1007/BF00866293

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