Sustained renal function loss in psoriasis patients after withdrawal of low-dose cyclosporin therapy

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Abstract
Eight patients with psoriasis received low-dose cyclosporin (CyA) treatment for an average period of 12 months (range 4–16 months). There was great variability in minimal effective CyA dose. In 50% of the patients long-term treatment was limited by dose reductions necessitated by side-effects. A considerable impairment of renal function during CyA therapy was found. Glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured with 125I-iothalamate and 131Ibippuran, respectively. Both at the end of the active treatment period (GFR-CyA and ERPF-CyA), and 4 months after withdrawal of CyA (GFR-4mo and ERPF-4mo), there was sustained renal impairment: GFR-BL = 97 (64–117), GFR-CyA reduction 17·8% (2·2–31·9%) P < 0·02], GFR-4mo reduction = 9·8% (5·5–21·5%) ml/min/1·73 m2 (P < 0·05 vs. BL); ERPF-BL = 401 (232–607), ERPF-CyA reduction =10·1% (7·4–27·3%) [P < 0·05], ERPF-4mo reduction=13·5% (3·0–32·9%) ml/min/1·73 m2 (P < 0·02). Further studies of the effects on renal function during, and after, long-term therapy of psoriasis with low-dose CyA are warranted.