CAJ | 학술논문

他克莫司是一种新型免疫抑制剂，可保护足细胞，降低尿蛋白。近年来研究表明他克莫司对多种慢性肾脏病的治疗有效，他克莫司治疗原发性膜性肾病（IMN）缓解率较环磷酰胺（CTX）方案提高；可有效安全治疗微小病变型肾病（MCD）；在难治性局灶性节段性肾小球硬化（FSGS）及难治性狼疮肾炎（LN）治疗中可降低蛋白尿，临床缓解率高，耐受性好；治疗激素抵抗型儿童肾病综合征疗效更好且安全。改善全球肾脏病预后（KDIGO）指南推荐他克莫司应用于 IMN、MCD、FSGS、LN 和儿童肾病综合征治疗。同时，他克莫司也可发生感染、震颤、失眠、血肌酐升高、高血糖、高血压和感觉异常等不良反应。因此，在肾脏病的治疗中应注意合理、有效和安全的使用。
타극막사시일충신형면역억제제，가보호족세포，강저뇨단백。근년래연구표명타극막사대다충만성신장병적치료유효，타극막사치료원발성막성신병（IMN）완해솔교배린선알（CTX）방안제고；가유효안전치료미소병변형신병（MCD）；재난치성국조성절단성신소구경화（FSGS）급난치성랑창신염（LN）치료중가강저단백뇨，림상완해솔고，내수성호；치료격소저항형인동신병종합정료효경호차안전。개선전구신장병예후（KDIGO）지남추천타극막사응용우 IMN、MCD、FSGS、LN 화인동신병종합정치료。동시，타극막사야가발생감염、진전、실면、혈기항승고、고혈당、고혈압화감각이상등불량반응。인차，재신장병적치료중응주의합리、유효화안전적사용。
Tacrolimus,a novel immunosuppressant,can protect podocytes and reduce urinary protein.Recent studies show that tacrolimus has higher remission rate than cyclophosphamide (CTX)in treatment of idiopathic membranous nephropathy (IMN).And tacrolimus therapy can effectively and safety treat minimal change nephropathy (MCD).Tacrolimus can also reduce proteinuria in both refractory focal segmental glomerulosclerosis (FSGS)and refractory lupus nephritis (LN)with good clinical remission rate and tolerability.Besides,tacrolimus has better efficacy and safety in treatment of steroid-resistant children nephrotic syndrome (NS).KDIGO (Kidney Disease:Improving Global Outcomes)guidelines recommend tacrolimus to be used in treatment of IMN,MCD,FSGS,LN,and children NS.However,there are some side effects of tacrolimus,including immunosuppression and infection,tremor,insomnia,elevated serum creatinine,high blood glucose,high blood pressure,and so on.Therefore,we should pay attention to the reasonable,effective and safe application of tacrolimus in treatment of kidney diseases.