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 investigated the clinical records of 1,323 kidney transplant recipients who received cyclosporin at 65 institutions in Japan from 1982 to 1991. METHOD: Renal biopsy was performed in 461 patients. RESULTS: At 5 years and 9 years after transplantation, the patients who had cyclosporin nephropathy associated with immunological rejection, glomerulonephritis, or both showed a significantly worse prognosis than those with cyclosporin nephropathy alone (p < 0.01). There was no significant difference in the loss of renal function at 9 years after transplantation between patients showing no abnormalities and patients with cyclosporin nephropathy alone. Even when cyclosporin nephropathy was absent, the long-term prognosis was unfavorable in recipients with immunological rejection or glomerulonephritis. CONCLUSIONS: These results suggest that cyclosporin nephropathy does not influence the prognosis of renal transplantation in patients on low-dose maintenance therapy with cyclosporin.