Abstract Calcineurin inhibitor (CNI) is a kind of widely used immunosuppressive drug. Ciclosporin A and Tacrolimus are commonly used in clinic. CNI exerts immunosuppressive effects by inhibiting T cell activation, inducing T cell apoptosis, and inhibiting the expression of various immune factors, and has significant therapeutic effects on autoimmune diseases such as systemic lupus erythematosus and membranous nephropathy. Meanwhile, CNI also has toxic side effects that can cause kidney damage. CNI can damage the glomerulus, renal microvasculature, renal tubules, and renal interstitium to varying degrees by activating the renin-angiotension-aldosterone system, destroying the balance of local vasoactive substances in the kidney, promoting oxidative stress, and other ways. Urinary retinol binding protein and other biomarkers may have some value in early detection of renal injury caused by CNI. Calcium channel blocker is considered as an effective means to alleviate CNI induced renal injury. This article aims to provide theoretical basis and prevention and treatment ideas for renal injury caused by CNI, and promote the rational and safe use of CNI in clinical practice.
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