Biesenbach G, Grafinger P, Kaiser W, Panuschka S, Stöger H, Stuby U, Zazgornik J
II. Medizinische Abteilung, des Allgemeinen Krankenhauses Linz.
Schweiz Med Wochenschr. 1988 Jun 18;118(24):939-43.
A 41-year-old female patient with analgesic nephropathy became pregnant 13 weeks after successful renal transplantation using cyclosporin as an immunosuppressant. Because of rhesus incompatibility of the mother this was thought to be a high risk pregnancy. In spite of the increased risk of CyA-induced nephrotoxicity in this early phase after transplantation, the patient showed the same physiological renal changes during pregnancy as healthy control patients: a 24% increase in creatinine clearance and an increase in protein excretion of only 41 mg/day. To maintain a CyA-blood concentration of 200-600 ng/ml throughout the pregnancy the CyA dose had to be increased from 380 to 550 mg daily or from 6.9 to 8.3 mg/kg/day (20%). This increase in CyA requirement may indicate additional metabolism of CyA by the fetal liver.
一名41岁患有镇痛剂肾病的女性患者，在成功进行肾移植并使用环孢素作为免疫抑制剂13周后怀孕。由于母亲的恒河猴血型不相容，这被认为是高危妊娠。尽管在移植后的这个早期阶段，环孢素诱导肾毒性的风险增加，但该患者在孕期表现出与健康对照患者相同的生理性肾脏变化：肌酐清除率增加24%，蛋白质排泄仅增加41毫克/天。为了在整个孕期维持环孢素血药浓度在200 - 600纳克/毫升，环孢素剂量必须从每日380毫克增加到550毫克，或从6.9毫克/千克/天增加到8.3毫克/千克/天（增加20%）。环孢素需求量的这种增加可能表明胎儿肝脏对环孢素进行了额外的代谢。
