El-Agroudy Amgad E, Ismail Amani M, Nassar Mohamed, Ghoneim Mohamed A
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Clin Exp Nephrol. 2009 Apr;13(2):156-160. doi: 10.1007/s10157-008-0111-0. Epub 2008 Dec 16.
The aim of the study was to assess whether the C(2) level is a good parameter to predict a drug's maximal concentration C(MAX) values in Egyptian kidney transplant recipients (KTR).
Fifty stable kidney transplant recipients (KTR) with a previously confirmed diagnosis of schistosomal infection compared to KTR (n = 50) without schistosomal infection regarding CsA concentrations at time 0 (trough), 1.5, 2, 2.5, 3, and 3.5 h post-CsA. Statistical significance of linear regression between different CsA time concentrations and drug dosages was calculated.
Patients in schistosomal group, had significantly lower C(2) levels (511 +/- 118 ng/ml) compared with control group (669 +/- 213 ng/ml) (P < 0.05), whereas C(2.5) level was significantly higher (730 +/- 215 and 527 +/- 129 ng/ml, respectively; P < 0.05). Only C(2.5) in schistosomal group had a significant linear regression relationship with both morning cyclosporine (CsA) dose and CsA dose expressed as mg/kg/day (P = 0.0123, r = 0.573018).
Egyptian patients have special characteristics in drug absorption and metabolism, mostly due to schistosomal infection, and they may need the use of C(2.5) for monitoring of CsA. If confirmed by subsequent larger experience, these findings may have a significant impact on our management of CyA immunosuppression in clinical renal transplantation in certain ethnicities.
