Treatment Class | Treatment Drug | Mode of action | Renal Complications | Notes |
Aminosalicylates | 5-aminosalicylic acid (5-ASA) | - Activates PPAR-gamma - Inhibit IL-1, IL-2 and TNF-α - Antioxidant effect | - Interstitial Nephritis | - Serum creatinine and GFR monitoring. (monthly for the first 3 months, and every 3 months for the remainder of the year and then annually) |
Sulphapyridine | ||||
TNF-α inhibitors | Infliximab | Chimeric anti-TNF IgG1 monoclonal antibody | - Membranous nephropathy (with absence of lupus nephritis) - Granulomatous interstitial nephritis - Tubulo-interstitial nephritis - Nephritic syndrome |
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Adalimumab | Recombinant anti-TNF IgG1 monoclonal antibody |
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calcineurin inhibitors
| Cyclosporin (CsA) | - Inhibits the phosphatase activity of calcineurin - Impairs the translocation of nuclear factor of activated T cells (NFAT) - Inhibits IL-2 transcription and T cells activation. | - Renal arteries vasoconstriction - Tubular intestinal fibrosis - Arteriolopathy | CsA treatment course should not exceed 4 to 6 months |
Tacrolimus (FK506) | - Kidney injury | - Blood trough levels of oral tacrolimus should range between 10 - 15 ng/ml - Preferably not to exceed 1 year of treatment. |