Pharmacokinetics of cyclosporine as a function of energy--protein deficiency in children with chronic renal failure
| Autor: | Alejandra R. Toledo, Guadalupe A. Camacho, María Gabriela Pérez Guillé, Joaquín Cravioto, Teresa Murguía, María del Carmen López, Amy B. Zaltzman-Rudy, Samuel Zaltzman, Ismael Lares-Asseff |
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| Rok vydání: | 1997 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Gastroenterology Child Nutrition Disorders Protein-Energy Malnutrition Pharmacokinetics Oral administration Internal medicine medicine Humans Pharmacology (medical) Child Pharmacology Volume of distribution business.industry Ciclosporin medicine.disease Kidney Transplantation Confidence interval Transplantation Endocrinology Cyclosporine Kidney Failure Chronic Female Complication business Immunosuppressive Agents medicine.drug Kidney disease |
| Zdroj: | Journal of clinical pharmacology. 37(3) |
| ISSN: | 0091-2700 |
| Popis: | The present study was conducted to determine whether malnutrition in patients with chronic renal failure requiring cyclosporine therapy for renal transplantation has some effect on the clinical pharmacokinetics of cyclosporine. Eleven pediatric patients were enrolled in this study before renal transplantation and divided into two groups (group I: six well-nourished patients with a deficit in weight/height ratioor = 7%; group II: five malnourished patients with a deficit in weight/height8%). The patients received a single oral dose of cyclosporine (3.0 mg/kg). Blood samples were collected for a 26-hour period, and serum concentrations of cyclosporine were measured using fluorescence-polarization immunoassay technology. The results suggest that, when malnutrition is present, the median Cmax of cyclosporine decreases by almost threefold (from 387.5 ng/mL in group I to 136.1 ng/mL in group II). An observed 52% reduction in AUC0-infinity (from 2,856.0 ng/mL/hr in group I to 1,481.4 ng/mL/hr in group II) was caused by the increased volume of distribution (from 4.6 L/kg in group I to 11.1 L/kg in group II). The elimination half-life (t1/2) was longer in group II compared with that of group I (12.4 hr for group II; range, 7.8-13.5 hr versus 8.9 hr for group I; range, 5.2-16.0 hr). Differences in t1/2 were not statistically significant at 5% confidence intervals. The effects of energy malnutrition on the pharmacokinetics of cyclosporine could explain in part some of the interindividual variability. This study provides pharmacokinetic guidelines for the use of cyclosporine. |
| Databáze: | OpenAIRE |
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