RENAL HISTOPATHOLOGIC ALTERATIONS IN PATIENTS TREATED WITH CYCLOSPORINE FOR UVEITIS
RENAL HISTOPATHOLOGIC ALTERATIONS IN PATIENTS TREATED WITH CYCLOSPORINE FOR UVEITIS
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DOI：
10.1056/nejm198605153142005
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发表时间：
1986-05-15
影响因子：
158.5
通讯作者：
NUSSENBLATT, RB
中科院分区：
文献类型：
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作者：
PALESTINE, AG;AUSTIN, HA;NUSSENBLATT, RB
为了评估与环孢素长期治疗相关的肾脏形态异常，我们从17例接受环孢素治疗平均两年的自身免疫性葡萄膜炎患者的经皮肾活检标本中获得。为了进行比较，我们还分析了没有接受环孢素A治疗的特发性血尿患者的肾活检样本。对标本中萎缩和硬化的肾小球和肾小管间质病变进行评估，以得出慢性化指数。接受环孢素治疗的患者的慢性指数显著高于对照组(P<；0.00005)。所有接受环孢素治疗的患者都有间质纤维化、肾小管萎缩或两者兼有。肾脏形态异常的一个很好的功能预测指标是患者S的血清肌酐超过基线50%的时间。即使在活检时肾功能正常的患者也可以看到慢性病理变化。结合肾功能的连续测量，肾活检可能在确定接受环孢素长期治疗的自身免疫性疾病患者可能出现的肾毒性的类型和程度方面发挥重要作用。
To evaluate abnormalities of renal morphology associated with long-term cyclosporin therapy, we obtained percutaneous renal biopsy specimens from 17 patients who had been treated for autoimmune uveitis with cyclosporine for an average of two years. For comparison, we also analyzed renal biopsy specimens from patients with idiopathic hematuria who had not received cyclosporine. The atrophic and sclerosing glomerular and tubulointerstitial lesions in the specimens were assessed to derive a chronicity index. The specimens from the patients treated with cyclosporine showed a significantly higher chronicity index than those from the controls (P < 0.00005). All patients who had received cyclosporine had interstitial fibrosis, tubular atrophy, or both. A good functional predictor of the abnormalities in renal morphology was the length of time that a patient''s serum creatinine had exceeded the base-line value by more than 50 percent. Chronic pathologic alterations were seen even in patients who had normal renal function at the time of the biopsy. In conjunction with sequential measurements of renal function, renal biopsy may have an important role in defining the type and degree of nephrotoxicity that can develop in patients receiving long-term cyclosporine therapy for autoimmune disease.