Cyclosporine-induced changes in glomerular filtration rate and urea excretion
Article Abstract:
Cyclosporine is a drug that suppresses immune mechanisms and is used to prevent organ rejection after transplantation. It is also used to treat various autoimmune diseases, such as rheumatoid arthritis and type I diabetes mellitus, in which abnormal immune factors cause damage to body tissues. Cyclosporine treatment has been associated with toxic effects on the kidneys, as indicated by increased blood urea nitrogen (BUN), suggesting impaired kidney excretion of nitrogen-containing wastes. The effects of cyclosporine therapy on kidney function were assessed in kidney transplant recipients, including 10 receiving azathioprine and prednisone and 9 treated with azathioprine, prednisone and cyclosporine. The patients were subjected to a slight reduction in blood volume by restricting their dietary salt intake and by use of the diuretic furosemide, which increases the elimination of water from the body. Cyclosporine-treated patients had lower clearances of the nitrogen-containing compounds urea and creatinine; decreased glomerular filtration rate, or the speed at which blood is filtered through the glomeruli, the capillaries within the kidney; increased BUN and amount of urea reabsorbed into the kidney; and greater decreases in sodium excretion. High amounts of sodium administered directly into the circulation resolved these abnormalities. The results show that cyclosporine treatment predisposes individuals to toxicity to the kidney. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Acute eosinophilic colitis and hypersensitivity reaction associated with naproxen therapy
Article Abstract:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and indomethacin, are widely used for arthritis, but can have damaging effects on the upper gastrointestinal (GI) tract, causing bleeding from the mucosal lining of the stomach and duodenum (upper small intestine). A case is reported of a patient who developed lower GI tract involvement after treatment the NSAID naproxen. The patient, a 57-year-old woman, had osteoarthritis of the hip and hand. After three weeks of naproxen, she developed watery non-bloody diarrhea with mild abdominal cramping. She had symptoms of a generalized hypersensitivity reaction, including a widespread red rash. Blood tests indicated liver function abnormalities, and high levels of eosinophils (a type of granular white blood cell). Originally, she was thought to have infectious diarrhea, but after three weeks, further evaluation was conducted. Biopsy of the colon showed infiltration by eosinophils and altered colonic wall structure. Naproxen was discontinued, and diarrhea halted within three days. Most cases of eosinophilic inflammation of the GI tract are chronic and of unknown cause, although an allergic basis is likely. Hypersensitivity to NSAID therapy has been previously described, but not with these features. Eosinophilic colitis and hypersensitivity may be one of the less frequent complications of NSAID therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
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Effects of sulindac and naproxen on prostaglandin excretion in patients with impaired renal function and rheumatoid arthritis
Article Abstract:
Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin are used to control pain and inflammation, and are important agents in treating arthritis. These drugs act by decreasing the synthesis of prostaglandins (PG), which are locally produced and locally acting hormones. Some NSAIDs may decrease PG production in the stomach and kidney, as well as the joints. In patients with kidney disease, locally produced PGs improve kidney function at several sites. Sulindac is a type of NSAID which is thought not to impair kidney (renal) PG function, and thus should be beneficial in treating patients with both arthritis and kidney disease. The effects of sulindac and naproxen, another NSAID, on the kidney function of 10 patients (8 female) with rheumatoid arthritis were evaluated. As expected, naproxen, but not sulindac, decreased urinary levels of PG. Renal blood flow and filtration rate were also decreased by naproxen, but not sulindac. Excretion of water, sodium, and potassium were not affected by either drug, but blood potassium levels increased during naproxen treatment. Both drugs were comparable in improving arthritic symptoms. The study suggests that short-term treatment of patients with kidney disease with sulindac appears to be relatively safe, and is preferable to NSAIDs with renal side effects. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1990
User Contributions:
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