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Chronic nephrotoxicity complicating cyclosporine treatment of chronic inflammatory demyelinating polyradiculoneuropathy

Departments of Neurology and Medicine (Division of Nephrology). Ohio State University, Columbus, OH.

We elected to use cyclosporin A (CsA) in a woman debilitated by refractory chronic inflammatory demyelinating polyradiculoneuropathy. Although strength improved coincident with CsA therapy, after 21 months she developed congestive heart failure and had a precipitous loss of renal function with chronic renal failure requiring hemodialysis. While most CsA-induced nephrotoxicity is dose related and reversible, the kidney biopsy in our patient showed chronic nephropathy, a complication previously unreported in the native kidney of a nontransplant patient. A slow rise in blood pressure preceded serum creatinine changes and was an early indicator of impending irreversible nephrotoxicity.

Address correspondence and reprint requests to Dr. Kolkin, Department of Neurology, Ohio State University, Columbus, OH 43210.

Received January 30, 1986. Accepted for publication April 22, 1986.

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