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Effects of cyclosporine on bone mineral density in patients with glucocorticoid-dependent nephrotic syndrome in remission

  • Nephrology - Original Paper
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Abstract

Purpose

Cyclosporine (CsA) is often prescribed to patients with glucocorticoid (GC)-dependent nephrotic syndrome. Although it is well known that long-term administration of GC causes osteoporosis, the effects of CsA on bone metabolism are not fully established. Therefore, we examined the effects of CsA on bone metabolism in patients with GC-dependent nephrotic syndrome in remission.

Methods

We followed 23 patients treated with prednisolone alone (GC alone group) and 17 patients treated with CsA in combination with prednisolone (GC + CsA group). Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and biochemical markers of bone metabolism were simultaneously measured in serum and urine samples.

Results

BMD decreased significantly in the GC group from 752 to 623 mg/cm2 but non-significantly in the GC + CsA group from 751 to 684 mg/cm2. Although the cumulative dose of GC increased in both groups, there were no significant differences in biochemical markers at either the start or the end of the study. Vertebrate bone fracture and other side effects associated with CsA treatment did not occur in our study.

Conclusions

Our results indicate that CsA does not accelerate GC-induced osteoporosis in patients with nephrotic syndrome. We conclude that CsA is appropriate for the treatment of GC-dependent nephrotic syndrome, because it does not adversely affect bone metabolism and has favorable glomerular effects.

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Conflict of interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Nephrology, Hypertension and Endocrinology, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashiku, Tokyo, 173-8610, Japan

    Chie Shimizu, Takayuki Fujita, Yoshinobu Fuke, Minako Yabuki, Mamiko Kajiwara, Seiichiro Hemmi & Masayoshi Soma

  2. Department of Laboratory Medicine, Nihon University School of Medicine, Tokyo, Japan

    Atsushi Satomura

  3. Department of General Medicine, Nihon University School of Medicine, Tokyo, Japan

    Masayoshi Soma

Authors
  1. Chie Shimizu
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  2. Takayuki Fujita
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  3. Yoshinobu Fuke
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  4. Minako Yabuki
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  5. Mamiko Kajiwara
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  6. Seiichiro Hemmi
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  7. Atsushi Satomura
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  8. Masayoshi Soma
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Correspondence to Takayuki Fujita.

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Shimizu, C., Fujita, T., Fuke, Y. et al. Effects of cyclosporine on bone mineral density in patients with glucocorticoid-dependent nephrotic syndrome in remission. Int Urol Nephrol 45, 803–808 (2013). https://doi.org/10.1007/s11255-012-0264-3

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  • DOI: https://doi.org/10.1007/s11255-012-0264-3

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