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

Adalimumab

Recombinant anti-TNF IgG1 monoclonal antibody

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.