Chronic cyclosporin-induced nephropathy

Aims: There is still no consensus about the prognostic influence of chronic nephropathy induced by low-dose maintenance therapy with cyclosporin. Our aim was to investigate the prognostic effect of cyclosporin nephropathy in Japanese renal transplant recipients. Material: We retrospectively investig ated the clinical records of 1323 kidney transplant recipients who received cyclosporin at 65 institutions in Japan from 1982 to 1991. Method: Renal b iopsy was performed in 461 patients. Results: At 5 years and 9 years after transplantation, the patients who had cyclosporin nephropathy associated wi th immunological rejection, glomerulonephritis, or both showed a significan tly worse prognosis than those with cyclosporin nephropathy alone (p < 0.01 ). There was no significant difference in the loss of renal function at 9 y ears after transplantation between patients showing no abnormalities and pa tients with cyclosporin nephropathy alone. Even when cyclosporin nephropath y was absent, the long-term prognosis was unfavorable in recipients with im munological rejection or glomerulonephritis. Conclusions: These results sug gest that cyclosporin nephropathy does not influence the prognosis of renal transplantation in patients on low-dose maintenance therapy with cyclospor in.