Hulton S A, Jadresic L, Shah V, Trompeter R S, Dillon M J, Barratt T M
Department of Paediatric Nephrology, Hospital for Sick Children, London, UK.
Pediatr Nephrol. 1994 Aug;8(4):404-7. doi: 10.1007/BF00856512.
Cyclosporin A (CyA) is now commonly used in the management of children with steroid-dependent nephrotic syndrome. In order to assess nephrotoxicity related to CyA therapy, we measured glomerular filtration rate (GFR) on 123 occasions in 24 children with minimal change nephrotic syndrome receiving CyA. GFR was estimated from the plasma clearance of 51chromium-EDTA every 3 months during CyA therapy of up to 27 months duration. There was a significant reduction in GFR after 3 months of CyA therapy [118 +/- 33 (SD) to 93 +/- 24 ml/min per 1.73 m2] but no further fall thereafter, although the reduction in GFR was sustained for the duration of CyA therapy. This reduction in GFR appeared to be reversible upon cessation of CyA, but careful monitoring of renal function is necessary in such patients to prevent the development of longer term nephrotoxic sequelae.
环孢素A（CyA）目前常用于治疗依赖类固醇的儿童肾病综合征。为了评估与CyA治疗相关的肾毒性，我们对24例接受CyA治疗的微小病变型肾病综合征患儿进行了123次肾小球滤过率（GFR）测量。在长达27个月的CyA治疗期间，每3个月通过51铬-乙二胺四乙酸的血浆清除率来估算GFR。CyA治疗3个月后，GFR显著降低[从118±33（标准差）降至93±24 ml/分钟/1.73 m2]，但此后未进一步下降，尽管在CyA治疗期间GFR持续降低。这种GFR的降低在停止使用CyA后似乎是可逆的，但对此类患者必须仔细监测肾功能，以防止出现长期肾毒性后遗症。
