Infrequent tacrolimus-induced nephrotoxicity in French patients with steroid-dependent nephrotic syndrome

Background Chronic nephrotoxicity with potentially irreversible lesions is a major concern regarding calcineurin inhibitor (CNI) treatment in children with severe forms of idiopathic nephrotic syndrome (INS). Case-diagnosis/Treatment We retrospectively included all children on CNI for steroid-depend...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric nephrology (Berlin, West) West), 2019-12, Vol.34 (12), p.2605-2608
Main Authors: Delbet, Jean Daniel, Aoun, Bilal, Buob, David, Degheili, Jad, Brocheriou, Isabelle, Ulinski, Tim
Format: Article
Language:English
Subjects:
Biopsy
Brief Report
Calcineurin
Calcineurin inhibitors
Care and treatment
Children
Complications and side effects
Creatinine
Demographic aspects
Fibrosis
Kidney diseases
Kidneys
Medicine
Medicine & Public Health
Mycophenolate mofetil
Mycophenolic acid
Nephrology
Nephrotic syndrome
Patient outcomes
Pediatrics
Tacrolimus
Urology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Chronic nephrotoxicity with potentially irreversible lesions is a major concern regarding calcineurin inhibitor (CNI) treatment in children with severe forms of idiopathic nephrotic syndrome (INS). Case-diagnosis/Treatment We retrospectively included all children on CNI for steroid-dependent INS with a duration of CNI treatment of more than 1 year. Only patients in whom CNI could not be replaced by mycophenolate mofetil were included. All included patients underwent a kidney biopsy. All results were expressed as median and range. Twenty-one children (6 girls) were included. Age at disease onset was 49 (29–66) months and treatment duration on CNI was 30 (20–45) months. Age at kidney biopsy was 108 (78–170) months. Number of relapses was 7 (3–9) since disease onset. Serum creatinine level was transiently and moderately increased in two patients. Kidney biopsy revealed minimal change disease in 20/21 patients and focal segmental glomerulosclerosis in 1/21. Evidence for chronic CNI nephrotoxicity was found in one patient revealed by arteriolar hyalinosis and fibrosis in 50% of glomeruli. Conclusions CNI-induced chronic nephrotoxicity was infrequent. In patients who require long-term and/or high-dose CNI treatment, kidney biopsies might be useful to exclude chronic CNI-induced lesions.
ISSN:0931-041X
1432-198X
DOI:10.1007/s00467-019-04343-2