Hami Maryam, Mojahedi Mohammad Javad, Naghibi Masih, Shakeri Mohammad Taghi, Sharifipour Farzaneh
Division of Nephrology, Department of Internal Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Iran J Kidney Dis. 2010 Apr;4(2):153-7.
Cyclosporine is the backbone of immunosuppression in kidney transplantation. However, it is associated with side effects, some of which are dose-dependent. We evaluated association between cyclosporine trough level and its side effects.
In 50 kidney transplant recipients, serum cyclosporine level, fasting blood glucose, and serum creatinine were measured 7 times during first 6 months after transplantation. The participants were also assessed for blood pressure, hand tremor, and headache at each visit. The relationship between cyclosporine trough level and hypertension, hyperglycemia, hand tremor, and headache were evaluated.
There were no significant relationship between cyclosporine levels and allograft function. Except at the second week and sixth month, there were no significant differences between drug doses in various serum cyclosporine trough level groups. At the second week, the mean drug dose in patients with cyclosporine trough levels less than the target therapeutic level was 279.16 +/- 56.23 mg/d, while in the patients with cyclosporine levels higher than the therapeutic level, its dose was 302.08 +/- 66.61 mg/d (P < .05). At the sixth month, the mean drug dose was 137.50 +/- 17.67 mg/d in the patients with lower than target cyclosporine levels, and it was 242.18 +/- 58.25 mg/d in those with cyclosporine levels higher than the therapeutic level (P < .05). There was no significant relationship between serum cyclosporine level and its side effects.
We demonstrated cyclosporine trough level had no direct relation with drug side effects and it is not a suitable measure for assessment of drug side effects.
环孢素是肾移植免疫抑制治疗的基础用药。然而，它会引发一些副作用，其中部分副作用与剂量相关。我们评估了环孢素谷浓度与其副作用之间的关联。
对50例肾移植受者在移植后的前6个月内进行了7次血清环孢素水平、空腹血糖和血清肌酐的检测。每次就诊时还对参与者的血压、手部震颤和头痛情况进行评估。评估环孢素谷浓度与高血压、高血糖、手部震颤和头痛之间的关系。
环孢素水平与移植肾肾功能之间无显著关系。除了在第2周和第6个月外，不同血清环孢素谷浓度组之间的药物剂量无显著差异。在第2周时，环孢素谷浓度低于目标治疗水平的患者平均药物剂量为279.16±56.23mg/d，而环孢素水平高于治疗水平的患者其剂量为302.08±66.61mg/d（P<.05）。在第6个月时，环孢素水平低于目标值的患者平均药物剂量为137.50±17.67mg/d，而环孢素水平高于治疗水平的患者其剂量为242.18±58.25mg/d（P<.05）。血清环孢素水平与其副作用之间无显著关系。
我们证明环孢素谷浓度与药物副作用无直接关系，它不是评估药物副作用的合适指标。
