Renal biopsy findings and followup of renal function in rheumatoid arthritis patients treated with cyclosporin A. An update from the international kidney biopsy registry

Abstract

OBJECTIVE: To review data from the International Kidney Biopsy Registry, which describes the occurrence of cyclosporin A (CSA)-induced nephropathy, and to discuss the potential risk factors for its development. METHODS: The report examines data on a total of 60 first and 14 second renal biopsies performed in rheumatoid arthritis (RA) patients treated with CSA for up to 87 months. RESULTS: Five of the 60 patients with RA included in the Biopsy Registry had findings consistent with CSA-induced nephropathy at first biopsy. One further patient had such findings at second biopsy. Of the 22 patients who started CSA at dosages < 4 mg/kg/day and subsequently received dosages no higher than 5 mg/kg/ day, none developed CSA-induced nephropathy. Continuous assessment of renal function did not show any evidence of deterioration over time in patients maintained on low-dose CSA. CONCLUSION: The data indicate that in RA patients being treated according to current dosing recommendations, the risk of developing CSA-induced nephropathy is low.