calcineurin inhibitor nephrotoxicity
Kidney damage caused by calcineurin inhibitor medications, characterized by afferent arteriolar vasoconstriction and chronic interstitial fibrosis.
Full Definition
Calcineurin inhibitor nephrotoxicity refers to the spectrum of kidney injury caused by medications such as cyclosporine and tacrolimus, commonly used as immunosuppressants in pediatric transplant recipients. The nephrotoxicity manifests as both acute and chronic forms: acute toxicity involves reversible afferent arteriolar vasoconstriction leading to decreased glomerular filtration rate, while chronic toxicity causes irreversible arteriolopathy, tubular atrophy, and interstitial fibrosis. In pediatric nephrology, this is particularly concerning in kidney transplant recipients where these medications are essential for preventing rejection but may paradoxically damage the transplanted kidney. Risk factors include high drug levels, concurrent use of other nephrotoxic agents, and dehydration. Monitoring requires regular trough levels and surveillance biopsies in transplant patients.
Usage
Usage note: Specify whether referring to acute (functional) or chronic (structural) nephrotoxicity and include drug levels when relevant.
In Context
- "Protocol biopsy revealed calcineurin inhibitor nephrotoxicity with arteriolopathy and striped fibrosis." — Transplant pathology report
- "Tacrolimus levels were reduced due to evidence of calcineurin inhibitor nephrotoxicity on surveillance biopsy." — Post-transplant follow-up note