Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Effect of cyclosporin on serum creatinine in patients with rheumatoid arthritis


Serum creatinine levels were measured before, during and after the administration of cyclosporin (Cy) in a double-blind placebo-controlled study in patients with rheumatoid arthritis (RA). The level rose significantly during and after Cy therapy, whereas the initial serum creatinine value did not change in the placebo group. The increase in the Cy group was not correlated with the mean Cy blood level. The rise in serum creatinine during Cy therapy was gradual and was not significantly correlated with the initial creatinine level; relative to the pretreatment value, the post-treatment increase was significantly correlated with the increase during Cy therapy. It is concluded that Cy administration for not more than 6 months, and at a maximum dosage of 10 mg/kg for 2 months, leads to an irreversible loss of more than 10% of renal function in RA patients. The damage may be ascribed to the combination of Cy with other factors compromising the kidneys, e.g., the use of non-steroidal anti-inflammatory drugs in the potentially systemic disorder of RA.

This is a preview of subscription content, log in to check access.


  1. 1.

    Calne RY, White DJG, Thiru S, Evans DB, McMaster P, Dunn DC, Craddock GN, Pentlow BD, Rolles K (1978) Cyclosporin A in patients receiving renal allografts from cadaver donors. Lancet 2: 1323–1327

  2. 2.

    Myers BD, Ross J, Newton L, Luetscher J, Perlroth M (1984) Cyclosporin-associated chronic nephropathy. N Engl J Med 311: 699–705

  3. 3.

    Chapman JR, Griffiths D, Harding NGL, Morris PJ (1985) Reversibility of cyclosporin nephrotoxicity after three months' treatment. Lancet 1: 128–129

  4. 4.

    Henny FC, Kleinbloesem CH, Moolenaar AJ, Paul LC, Breimer DD, Van Es LA (1985) Pharmacokinetics and nephrotoxicity of cyclosporin A in renal transplant recipients. Transplantation 40: 261–265

  5. 5.

    Palestine AG, Nussenblatt RB, Chi-Chao Chan (1984) Side-effects of systemic cyclosporin in patients not undergoing transplantation. Am J Med 77: 652–656

  6. 6.

    Cockroft DW, Gault MH (1976) Prediction of creatinine clearance from serum creatinine. Nephron 16: 31–41

  7. 7.

    Donatsch P, Abisch E, Homberger M, Traber R, Trapp M, Voges R (1981) A radioimmunoassay to measure cyclosporin A in plasma and serum samples. J Immunoassay 2: 19–32.

  8. 8.

    Van Rijthoven AWAM, Dijkmans BAC, Goei The HS, Hermans J, Montnor-Beckers ZLBM, Jacobs PJC, Cats A (1986) Cyclosporin treatment for rheumatoid arthritis: A placebo-controlled double-blind multicentre study. Ann Rheum Dis 45: 726–731

  9. 9.

    Strom TB, Loertscher R (1984) Cyclosporin-induced nephrotoxicity. N Engl J Med 311: 728–729

  10. 10.

    Dijkmans BAC, van Hooff JP, de Wolff FA, Mattie M (1981) The effect of co-trimoxazole on serum creatinine. Br J Clin Pharmacol 12: 701–703

  11. 11.

    Morris PJ, French ME, Dunnhill MS, Hunnisett AGW, Ting A, Thompson JF, Wood RFM (1983) A controlled trial of cyclosporin in renal transplantation with conversion to azathioprine and prednisolone after three months. Transplantation 36: 273–277

  12. 12.

    Nived O, Sturfelt G, Westling H, White T (1983) Is serum creatinine concentration a reliable index of renal function in rheumatic diseases? Br Med J 286: 684–685

  13. 13.

    Breedveld FC, Valentijn RM, Westedt ML, Weening J (1985) Rapidly progressive glomerulonephritis with glomerular crescent formation in rheumatoid arthritis. Clin Rheumatol 4: 353–359

  14. 14.

    Kimberly RP, Bowden RE, Keiser HR, Plotz PH (1978) Reduction of renal function by newer nonsteroidal anti-inflammatory drugs. Am J Med 64: 804–807

  15. 15.

    Wegmueller E (1985) Nicht-steroidale Antirheumatika und Nephrotoxizität. Dtsch Med Wochenschr 110: 469–472

Download references

Author information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Dijkmans, B.A.C., van Rijthoven, A.W.A.M., Goei The, H.S. et al. Effect of cyclosporin on serum creatinine in patients with rheumatoid arthritis. Eur J Clin Pharmacol 31, 541–545 (1987).

Download citation

Key words

  • cyclosporin
  • rheumatoid arthritis
  • serum creatinine
  • renal damage
  • serum cyclosporin