Developmental changes of MPA exposure in children

Autor: Elisa C. Yoo, Guido Filler, Ekaterina Kirilova Todorova, Ana Catalina Alvarez-Elías
Rok vydání: 2016
Předmět:
Adult
Graft Rejection
Male
medicine.medical_specialty
Adolescent
030232 urology & nephrology
Serum albumin
Renal function
Pharmacology
Hematocrit
030226 pharmacology & pharmacy
Gastroenterology
Tacrolimus
Mycophenolic acid
Young Adult
03 medical and health sciences
Child Development
IMP Dehydrogenase
0302 clinical medicine
Internal medicine
Humans
Medicine
Enzyme Inhibitors
Renal Insufficiency
Chronic
Child
Retrospective Studies
Sirolimus
Body surface area
medicine.diagnostic_test
biology
business.industry
Age Factors
Mycophenolic Acid
Kidney Transplantation
Cystatin C
Nephrology
Therapeutic drug monitoring
Child
Preschool
Pediatrics
Perinatology and Child Health
biology.protein
Trough level
Drug Therapy
Combination
Female
Drug Monitoring
business
Immunosuppressive Agents
Follow-Up Studies
Glomerular Filtration Rate
medicine.drug
Zdroj: Pediatric Nephrology. 31:975-982
ISSN: 1432-198X
0931-041X
DOI: 10.1007/s00467-015-3303-3
Popis: Developmental changes (ontogeny) of drug disposition of Mycophenolate mofetil (MMF) have been understudied. The charts of 37 pediatric renal transplant recipients (median age 7.3 years, median follow-up 7.8 (IQR 6.6, 14.3 years) who had regular mycophenolic acid (MPA) trough level monitoring in combination with tacrolimus (n = 31) or sirolimus (n = 6) therapy were analyzed retrospectively for their dose-normalized MPA exposure, steroid dose, albumin, hematocrit, and cystatin C estimated glomerular filtration rate (eGFR). Using appropriate univariate and multivariate methods, we determined whether MPA exposure was age dependent when controlling for the confounders. Dose-normalized MPA trough levels could be calculated in 2,128 (median 45/patient) instances. Spearman rank correlation analysis revealed that age correlated with dose-normalized MPA trough level for both body weight and body surface area, as well as serum albumin, hematocrit, steroid dose, and eGFR. In the multivariate analysis, serum albumin and steroid dose were not significant, and hematocrit only being significant when the youngest group of patients
Databáze: OpenAIRE
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