One of the following caused nephrotoxicity -
Tacrolimus Tacrolimus is a macrolide immunosuppressant that is isolated from bacterium. It is used for the same purpose as cyclosporine i.e., it is being used to protect and treat liver and kidney grafts when conventional immunosuppressants fail. It suppresses the cell mediated immunity but it leaves patient with enough immunity to fight bacteria. Despite major differences in the chemical structure, tacrolimus and cyclosporine seems to have many effects in common:? It acts like cyclosporine Both the drugs inhibit the calcineurin pathways. Their adverse effect on kidney is indistinguishable i.e., - Tubular lesions - Aeriolopathy - Tufts like changes in glomeruli and vessels. Adverse effect of Azathioprine (Goodman Gilman 12th/e p. 1415) Bone marrow Suppression - Leucopenia (common) - Thrombocytopenia (less common) Increased susceptibility to infections Hepatotoxicity Alopecia G.I.toxicity Pancreatitis Increased risk of neoplasia Adverse effects of mycophenolate mofetil (Goodman Gilman 12th/e p1414) Gastrointestinal - Diarrhoes - Vomiting Hematological - Leucopenia - Anemia - Thrombocytopenia Sepsis associated with cytomegalovirus Adverse lipid profile Increased risk of malignancy and pancreatitis Abnormal liver functions tests - Hepatitis - Electrolyte disturbance Adverse effect of Leflunomide Diarrhoea (40%) Other gastrointestinal disturbances Allergic responses Alopecia Hypeension Leucopenia Abnormal liver function tests
Azathioprine
Cyclophosphamide
Mycophenolate mofetil
Tacrolimus