Raj D S, Somiah S, Mani K
Department of Nephrology, Kidwai Memorial Institute of Oncology.
J Assoc Physicians India. 1996 Jan;44(1):34-6.
Thirty consecutive adult patients who underwent renal transplantation were prospectively studied. The immunosuppression consisted of cyclosporine, azathioprine and prednisolone. Oral Cyclosporine CyA was initiated at a dose of 7 mg/kg/Day and reduced by 1 mg/kg/month. Blood level of CyA was monitored by monoclonal RIA (Cyclo-Trac-NS) method on 3rd, 10th, 30th, 60th, 90th and 180th days. The dose was titrated according to the blood level and the renal function. In spite of progressive reduction in the dose of CyA, the blood level did not show any significant change, probably because of increased absorption or decreased metabolism. Though the percentage change in CyA dose was significant, the CyA level and serum creatinine remained relatively stable during the follow up period. Our patients required relatively lesser dose to achieve optimum blood level. Though the blood level of CyA ranged between 387 and 2120 ng/dL. There was no evidence of rejection or irreversible nephrotoxicity.
对30例连续接受肾移植的成年患者进行了前瞻性研究。免疫抑制方案包括环孢素、硫唑嘌呤和泼尼松龙。口服环孢素（CyA）起始剂量为7mg/kg/天，每月减少1mg/kg。在第3、10、30、60、90和180天，采用单克隆放射免疫分析法（Cyclo-Trac-NS）监测CyA血药浓度。根据血药浓度和肾功能调整剂量。尽管CyA剂量逐渐减少，但血药浓度未显示出任何显著变化，这可能是由于吸收增加或代谢减少所致。虽然CyA剂量的百分比变化显著，但在随访期间CyA水平和血清肌酐保持相对稳定。我们的患者达到最佳血药浓度所需的剂量相对较少。虽然CyA血药浓度在387至2120ng/dL之间，但没有排斥反应或不可逆肾毒性的证据。
