What is the role of cyclosporin A (CSA) in the treatment of frequently relapsing nephrotic syndrome (FRNS)?

Updated: Mar 04, 2020
  • Author: Jerome C Lane, MD; Chief Editor: Craig B Langman, MD  more...
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Answer

Cyclosporin A

CSA treatment is started at 3-5 mg/kg/day divided every 12 hours; doses are adjusted for trough concentrations of 50-125 ng/mL. However, trough levels correlate poorly with area-under-the-curve (AUC) pharmacokinetics and may not represent true exposure to CSA. Levels obtained 2 hours after administration have a better correlation with AUC. [76]

Kidney function and drug levels must be carefully monitored because of the risk of CSA-induced nephrotoxicity.

Low-dose steroids are continued for a variable length of time. As many as 40% of patients may need to remain on steroids during CSA treatment to maintain remission. [41, 59]


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