低剂量环孢素治疗停药后银屑病患者肾功能持续丧失。

Sustained renal function loss in psoriasis patients after withdrawal of low-dose cyclosporin therapy.

作者信息

Korstanje M J, Bilo H J, Stoof T J

机构信息

Department of Dermatology, University Hospital, Leiden, The Netherlands.

出版信息

Br J Dermatol. 1992 Nov;127(5):501-4. doi: 10.1111/j.1365-2133.1992.tb14848.x.

DOI:10.1111/j.1365-2133.1992.tb14848.x

PMID:1467290

Abstract

Eight patients with psoriasis received low-dose cyclosporin (CyA) treatment for an average period of 12 months (range 4-16 months). There was great variability in minimal effective CyA dose. In 50% of the patients long-term treatment was limited by dose reductions necessitated by side-effects. A considerable impairment of renal function during CyA therapy was found. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured with 125I-iothalamate and 131I-hippuran, respectively. Both at the end of the active treatment period (GFR-CyA and ERPF-CyA), and 4 months after withdrawal of CyA (GFR-4mo and ERPF-4mo), there was sustained renal impairment: GFR-BL = 97 (64-117), GFR-CyA reduction 17.8% (2.2-31.9%) [P < 0.02], GFR-4mo reduction = 9.8% (5.5-21.5%) ml/min/1.73 m2 (P < 0.05 vs. BL); ERPF-BL = 401 (232-607), ERPF-CyA reduction = 10.1% (7.4-27.3%) [P < 0.05], ERPF-4mo reduction = 13.5% (3.0-32.9%) ml/min/1.73 m2 (P < 0.02). Further studies of the effects on renal function during, and after, long-term therapy of psoriasis with low-dose CyA are warranted.

摘要

8例银屑病患者接受低剂量环孢素（CyA）治疗，平均治疗期为12个月（范围4 - 16个月）。最小有效CyA剂量存在很大差异。50%的患者长期治疗因副作用导致剂量减少而受限。发现CyA治疗期间肾功能有相当程度的损害。分别用125I - 碘肽酸盐和131I - 马尿酸测定肾小球滤过率（GFR）和有效肾血浆流量（ERPF）。在积极治疗期结束时（GFR - CyA和ERPF - CyA）以及停用CyA后4个月（GFR - 4mo和ERPF - 4mo），均存在持续性肾功能损害：GFR - BL = 97（64 - 117），GFR - CyA降低17.8%（2.2 - 31.9%）[P < 0.02]，GFR - 4mo降低 = 9.8%（5.5 - 21.5%）ml/min/1.73 m2（与BL相比P < 0.05）；ERPF - BL = 401（232 - 607），ERPF - CyA降低 = 10.1%（7.4 - 27.3%）[P < 0.05]，ERPF - 4mo降低 = 13.5%（3.0 - 32.9%）ml/min/1.73 m2（P < 0.02）。有必要进一步研究低剂量CyA长期治疗银屑病期间及之后对肾功能的影响。