NEPHROTOXICITY IN BONE-MARROW TRANSPLANT RECIPIENTS TREATED WITH CYCLOSPORIN-A
NEPHROTOXICITY IN BONE-MARROW TRANSPLANT RECIPIENTS TREATED WITH CYCLOSPORIN-A
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DOI：
10.1111/j.1365-2141.1983.tb02068.x
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发表时间：
1983-01-01
影响因子：
6.5
通讯作者：
GORDONSMITH, EC
中科院分区：
文献类型：
--
作者：
HOWS, JM;CHIPPING, PM;GORDONSMITH, EC
环孢素A （CyA）是一种有价值的同种异体骨髓移植后免疫抑制剂。CyA的使用与移植物抗宿主病严重程度的降低和骨髓移植的改善有关。CyA的一个主要副作用是肾毒性。在治疗前4周研究的33例患者中，谷（12 h）血清环孢素a浓度与血浆肌酐（r = 0.93, P < 0.001）和尿素（r = 0.88, P < 0.001）密切相关。血清中CyA浓度为bb0 ~ 500 ng/ml时具有潜在的肾毒性。环孢素治疗早期肾毒性的其他危险因素是同时使用氨基糖苷类抗生素[妥布霉素和美洛西林]（P = 0.01）和高胆红素血症（P = 0.01）。早期肾毒性可以通过将CyA水平维持在100-400 ng/ml范围内来预防。在长期CyA治疗期间，可发生累积性肾损害，少数患者可出现与微血管病变性外周血改变和高血压相关的肾毒性发作。
Cyclosporin A (CyA) is a valuable post graft immunosuppressive agent in allogeneic bone marrow transplantation. The use of CyA is associated with a reduction in severity of graft vs. host disease and improved marrow engrafgment. A major side effect of CyA is nephrotoxicity. In 33 patients studied during the first 4 wk of therapy, there is a close correlation between trough (12 h) serum cyclosporin A concentrations and plasma creatinine (r = 0.93, P < 0.001) and urea (r = 0.88, P < 0.001). Trough CyA serum concentrations of > 500 ng/ml are potentially nephrotoxic. Other risk factors for early nephrotoxicity in cyclosporin therapy are the concurrent use of aminoglycoside antibiotics [tobramycin and mezlocillin] (P = 0.01) and hyperbilirubinemia (P = 0.01). Early nephrotoxicy can be prevented by maintaining trough CyA levels in the range 100-400 ng/ml. During prolonged CyA therapy, cumulative renal impairment can occur and nephrotoxic episodes associated with microangiopathic peripheral blood changes and hypertension are seen in a minority of patients.