Renal interstitial fibrosis in @entity1 treated with XXXX for @entity1985 .

@entity1 @entity82 @entity177 @entity134 @entity194 @entity1140 @entity1985
BACKGROUND: @entity134 -dependent, @entity134 -resistant or frequently relapsing @entity1985 carries a poor prognosis, including progression to @entity177 . There are a number of studies confirming the efficacy of @entity1140 in @entity134 -resistant or @entity134 -dependent @entity1985 . Although the use of this medication is becoming more common, we know very little about the potential nephrotoxicity when used in @entity1985 . METHOD: We retrospectively reviewed the characteristics and biopsy findings of 11 @entity1 with @entity134 -dependent or frequently relapsing @entity1985 treated with @entity1140 . Two sequential biopsies were evaluated for the change in @entity82 , measured by a quantitative stereological method, and the change in @entity194 and @entity82 , graded according to Banff criteria. RESULTS: There was an increase in @entity82 (P   = 0.005), with a median absolute change in the per cent volume density between initial and follow-up biopsies of 1.8% [interquartile range (IQR) 3.9%]. Median percentage change in volume density of @entity82 , relative to volume density of @entity82 prior to initiating @entity1140 , was 93% (IQR 138%). Banff scores for @entity82 and @entity194 also increased following @entity1140 therapy (P   =   0.04 for both). Average @entity1140 trough level over the treatment period was significantly associated with change in @entity82 (Spearman's rho = 0.67 and P =   0.02). CONCLUSIONS: This is some of the first histological data concerning @entity1140 nephrotoxicity in childhood @entity1985 . Although the role of the natural progression of the underlying disease in the observed change is not definitively clear, the changes seen are in keeping with the known nephrotoxic effects of @entity1140 demonstrated in renal transplant. This increase is small when presented as a median change. However, there were a number of @entity1 who had a larger change in @entity82 . The factors predictive of @entity82 while on @entity1140 are not well defined; the findings from this study suggest that @entity1140 level may be a factor. Given the observations and limitations of the few published studies, there is an obvious need for further study in a large multicenter prospective trial.
