[Role of hepatic monooxygenase activity study in optimization of immunosuppressive therapy and optimal use of ketoconazole in patients with transplanted kidney].

The aim of the study is to evaluate the activity of hepatic monooxidase enzymic system (MOS) in patients with chronic renal failure before and after transplantation of the kidney, to elucidate the relationship between MOS activity and clinical features of the disease, to validate effective dose of MOS inhibitor ketokonasole. MOS activity was measured by antipirine half-life. By initial MOS activity, three groups of oxidizers were recognized: fast, moderate, slow. Native population of the North and some ethnic groups prevailed among fast "oxidizers". MOS activity measured 2 months after transplantation of the kidney was characterized by a spontaneous fall of MOS activity, recovery of renal elimination. Fast "oxidizers" demonstrated greater frequency of acute rejection, less frequent episodes of cyclosporine nephrotoxicity, higher cumulative dose of steroid hormones and weak response to azatioprin. Effective dose of ketokonasole was within 100-200 mg/day under the same pharmacodynamic effect. It was found reasonable to measure MOS activity for decision about administration of optimal immunosuppressive therapy and ketokonasole.