Brou Nguessan Aimé, Jacqz-Aigrain Evelyne, Zhao Wei
Department of Paediatric Pharmacology and Pharmacogenetics, Hôpital Robert Debré, APHP, Paris, France.
Department of Clinical Pharmacy and Therapeutics, School of Pharmaceutical Sciences, Université Félix Houphouët-Boigny, Abidjan, Ivory Coast.
Br J Clin Pharmacol. 2015 Jul;80(1):20-7. doi: 10.1111/bcp.12602. Epub 2015 May 28.
The objective of the present study was to review the available pharmacokinetic evidence for the utility of cystatin C (CysC) as a marker of renal function to predict the dose of renally excreted drugs.The bibliographic search used PubMed and EMBASE databases, from its inception through to January 2014, with the following keywords 'pharmacokinetics' and 'cystatin C'.Sixteen pharmacokinetic publications were identified and seven drugs primarily excreted by the kidney were studied. Among them, only one study was performed in children, the others were performed in adults and/or elderly subjects, either healthy volunteers or patients with variable clinical conditions, such as cystic fibrosis and cancer. Most of studies (n = 13/16) demonstrated that CysC was better correlated with clearance/trough concentration of evaluated drugs compared with creatinine.Our review supports that CysC is a good marker of renal function to predict dose of renally excreted drugs. Efforts should be made to evaluate the impact of CysC in special populations in order to define its clinical value in dosing optimization.
本研究的目的是回顾胱抑素C（CysC）作为肾功能标志物以预测经肾脏排泄药物剂量的现有药代动力学证据。文献检索使用了PubMed和EMBASE数据库，检索时间从建库至2014年1月，关键词为“药代动力学”和“胱抑素C”。共识别出16篇药代动力学出版物，并对7种主要经肾脏排泄的药物进行了研究。其中，仅1项研究在儿童中开展，其他研究在成人和/或老年受试者中进行，受试者包括健康志愿者或患有各种临床疾病（如囊性纤维化和癌症）的患者。大多数研究（n = 13/16）表明，与肌酐相比，CysC与所评估药物的清除率/谷浓度具有更好的相关性。我们的综述支持CysC是预测经肾脏排泄药物剂量的良好肾功能标志物。应努力评估CysC在特殊人群中的影响，以确定其在给药优化中的临床价值。
