Vellingiri Priyatharsini, Krishnamurthy Sriram, Sundaram Rajan, Ramachandran Suganthi S
Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Department of Pediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Indian Pediatr. 2025 Sep 8. doi: 10.1007/s13312-025-00177-4.
To determine the cyclosporine trough (C) and two-hour post-dose concentrations (C) in children with nephrotic syndrome (NS) and study the factors influencing them.
In this ambispective cohort study, children with NS (including frequently relapsing, steroid-dependent and steroid-resistant nephrotic syndrome) on cyclosporine therapy were enrolled. Clinical and laboratory data were recorded. C and C were estimated using liquid chromatography mass spectrometry.
Among 27 patients with a mean (SD) age of 6.4 (4.1) years, the median (Q1, Q3) of C and C were 114.8 (86.1, 186.3) ng/mL and 661.6 (442.1, 884.6) ng/mL, respectively. At a mean (SD) cyclosporine dose of 4.1 (0.8) mg/kg/day, 12 (44%) patients had C above and 4 (15%) below the therapeutic range (80-120 ng/mL). C levels were outside the recommended ranges in 17 (63%) children, within range in 7 (26%), and below in 3 (11%). Capsule users had higher C than syrup users. Amlodipine therapy was associated with higher C levels.
Nearly half the children had C and C levels outside the therapeutic range. Dosage form and amlodipine influenced C, not C concentrations.
测定肾病综合征（NS）患儿的环孢素谷浓度（C）和给药后两小时浓度（C），并研究影响这些浓度的因素。
在这项双向队列研究中，纳入接受环孢素治疗的NS患儿（包括频繁复发、激素依赖和激素抵抗型肾病综合征）。记录临床和实验室数据。采用液相色谱质谱法估算C和C。
27例患儿的平均（标准差）年龄为6.4（4.1）岁，C和C的中位数（四分位数间距）分别为114.8（86.1，186.3）ng/mL和661.6（442.1，884.6）ng/mL。环孢素平均（标准差）剂量为4.1（0.8）mg/kg/天，12例（44%）患儿的C高于治疗范围（80 - 120 ng/mL），4例（15%）低于治疗范围。17例（63%）患儿的C水平超出推荐范围，7例（26%）在范围内，3例（11%）低于范围。服用胶囊剂型的患儿C高于服用糖浆剂型的患儿。氨氯地平治疗与较高的C水平相关。
近一半患儿的C和C水平超出治疗范围。剂型和氨氯地平影响C浓度，而非C浓度。
