Renal biopsy findings in long-term cyclosporin treatment of psoriasis

• Published in: British journal of dermatology (1951) Vol. 136; no. 4; pp. 531 - 535
• Main Authors: ZACHARIAE, H., KRAGBALLE, K., HANSEN, H.E., MARCUSSEN, N., OLSEN, S.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.04.1997; Blackwell
• Subjects: Adult; Aged; Biological and medical sciences; Biopsy, Needle; Cyclosporine - adverse effects; Cyclosporine - therapeutic use; Dermatology; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Immunosuppressive Agents - adverse effects; Immunosuppressive Agents - therapeutic use; Kidney - pathology; Kidney Diseases - chemically induced; Kidney Diseases - pathology; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Psoriasis - drug therapy; Psoriasis. Parapsoriasis. Lichen; Skin, nail, hair, dermoskeleton; Human; Pathology; Skin disease; Chemotherapy; Treatment; Psoriasis; Kidney
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1046/j.1365-2133.1997.6101586.x

Summary Renal biopsies were performed in 30 psoriatics during long‐term low‐dose cyclosporin (CsA) therapy (range 2·5–6 mg/kg per day) of from 6 months to 8 years. The study included pretreatment biopsies in 25 of the patients. After 2 years all biopsies shared features consistent with CsA nephropathy despite completely normal pretreatment morphology in 17 of the 25 patients. The severity of the findings which consisted of arteriolar hyalinosis, focal interstitial fibrosis and sclerotic glomeruli increased with length of therapy. Mild renal lesions were seen durhig the first 2 years. After 4 years all but one had arteriolar hyalinosis. with interstitial fibrosis pronounced in live and moderate in six of 11 patients. At the same time glomerular sclerosis had become significant. A decrease in glomerular filtration rate (GFR) correlated with severity of structural lesions. The data from our study together with experiences from cardiac‐transplanted patients treated with CsA indicate that patients with psoriasis after 2 years therapy with CsA should be rotated to other treatments or be followed carefully by GFR and sequential renal biopsies.