Nephrotoxic aspects of cyclosporine

Transplant Proc. 2004 Mar;36(2 Suppl):234S-239S. doi: 10.1016/j.transproceed.2004.01.011.


Over the last 20 years cyclosporine (CsA) has improved the survival of kidney, heart, and liver transplants. However, with increasing use, evidence has accumulated that CsA therapy carries a variety of side effects, the most important being renal toxicity. CsA can lead to a wide spectrum of renal function impairments, including a marked and rapidly reversible decrease in renal hemodynamics (acute CsA nephrotoxicity), and a chronic form of renal damage that potentially progress irreversibly to end-stage renal disease (chronic CsA nephrotoxicity). All these manifestations are the consequence of the drug toxic effects on renal vessels and the tubulointerstitium. A proper diagnosis of CsA toxicity at early stages, the combination of low CsA doses with non-nephrotoxic immunosuppressants, and the development of more feasible strategies to monitor daily CsA exposure may contribute to a better CsA management, improve quality of life of transplant recipients, and prolong graft survival.

Publication types

  • Review

MeSH terms

  • Chronic Disease
  • Cyclosporine / toxicity*
  • Hemolytic-Uremic Syndrome / chemically induced
  • Humans
  • Immunosuppressive Agents / toxicity
  • Kidney / drug effects
  • Kidney / pathology*
  • Kidney Transplantation / immunology
  • Renin-Angiotensin System / drug effects


  • Immunosuppressive Agents
  • Cyclosporine