Primary glomerulonephritis (GN) is an autoimmune disease which is not only one of the main causes of chronic renal failure, but also an important clinic and public health problem in Taiwan. Among immunosuppressive agents, corticosteroids is the first line of choice for management of primary GN, immunomodulators or cytotoxic agents is the second one. Cyclosporine A (CsA) is proved to achieve remission in most of GN cases, but some GN were failed to treat by CsA, or became CsA-dependent, so it is necessary to consider alternative agents. As CsA, tacrolimus (Prograf®) has a high selectiveness of T-cell and similar mechanisms. There had many case reports and some small-scale clinical trials showed that tacrolimus can replace CsA in cases of FSGS or MGN with failure to corticosteroids or CsA therapy. There is some evidences that tacrolimus is feasible to treat primary GN. Tacrolimus shows lower toxicity and less adverse effects than CsA in many studies of organ transplantation. Though the evidences are fewer, the replacement of CsA by tacrolimus should be a rational choice in primary GN patients who had poor response to CsA.
|Number of pages||6|
|Journal||Journal of Internal Medicine of Taiwan|
|Publication status||Published - 2006 Aug|
All Science Journal Classification (ASJC) codes
- Internal Medicine