Korean J Dermatol.  2021 Jul;59(6):426-433.

The Association between Cumulative Dose of Cyclosporine and Renal Function Abnormality in Dermatology Patients Managed with Low Dose Regimen

• Kim JW
• Kim M
• Kim BR
• Youn SW

Abstract

Background
Cyclosporine (CsA), an immunosuppressant that specifically regulates T-lymphocytes, has long been used in dermatology practice. However, nephrotoxicity, a well-known adverse effect associated with high-dose (≥5 mg/kg/d) and long-term administration (≥2 years) has limited the use of CsA.
Objective
We investigated the association between the cumulative dose of CsA and renal dysfunction, as well as the long-term effects of low-dose CsA on renal function in patients who presented with dermatological conditions.
Methods
The study included 697 patients who received CsA at an outpatient dermatology clinic between January 2015 and May 2019. Logistic regression analysis was performed to determine the association between the cumulative dose of CsA and renal dysfunction.
Results
Compared with patients who received the lowest cumulative dose (˂7,000 mg), those who received the highest cumulative dose of CsA (≥30,600 mg) showed a 64% higher risk of renal dysfunction; however, the difference was not statistically significant (odds ratio 1.64, 95% confidence interval 0.39∼6.84).
Conclusion
Among patients who receive a low-dose CsA regimen, those who are treated with cumulative doses higher than the critical value may be predisposed to renal dysfunction, whereas those treated with a cumulative dose lower than the critical value are unlikely to develop nephrotoxicity.

Keyword

Abnormalities; drug-induced; Blood urea nitrogen; Creatinine; Cyclosporine; Kidney function tests