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Decreased cyclosporine exposure during the remission of nephrotic syndrome

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Abstract

In this paper, we report the pharmacokinetics changes observed in seven children with steroid-resistant nephrotic syndrome (SRNS). They received cyclosporine A (CsA) microemulsion 6 mg/kg/day and, one week later, they were admitted to perform a 12-h pharmacokinetic profile with eight time sample points. The pharmacokinetic profile was repeated at 24 weeks of treatment, when all patients achieved remission. Blood concentration against time curves were constructed for each patient at weeks 1 and 24 of CsA treatment. Peak concentrations (C max) and the time needed to reach peak concentrations (t max) were directly determined from these plots. The area under the curve (AUC) was estimated by the trapezoidal rule. There was a statistically significant difference of the AUC, trough levels, and t max between weeks 1 and 24, with a decrease of AUC from 5,211 ng*h/ml in week 1 to 3,289 ng*h/ml in week 24, the trough levels decreased from 157 ng/ml to 96 ng/ml, and the t max decreased from 1.85 h to 1.00 h. The higher CsA bioavailability during the nephrotic state has to be considered when managing patients, since the target AUC cannot be the same throughout the treatment.

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Authors and Affiliations

  1. Departamento de Nefrología, Hospital Infantil de México Federico Gómez, Dr. Márquez 162 Colonia Doctores, México D.F., CP 06720, Mexico

    Mara Medeiros & Ricardo Muñoz

  2. Laboratorio de Farmacología y Fisiología, Facultad de Química UASLP, México, Mexico

    José Pérez-Urizar

  3. Hospital Universitario Fundación Santafé de Bogotá, Bogotá, Colombia

    Natalia Mejía-Gaviria

  4. Departamento de Farmacología, Hospital Infantil de México Federico Gómez, México, Mexico

    Eduardo Ramírez-López

  5. Sección Externa de Farmacología, CINVESTAV IPN, México, Mexico

    Gilberto Castañeda-Hernández

Authors
  1. Mara Medeiros
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  2. José Pérez-Urizar
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  3. Natalia Mejía-Gaviria
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  4. Eduardo Ramírez-López
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  5. Gilberto Castañeda-Hernández
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  6. Ricardo Muñoz
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Correspondence to Mara Medeiros.

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Medeiros, M., Pérez-Urizar, J., Mejía-Gaviria, N. et al. Decreased cyclosporine exposure during the remission of nephrotic syndrome. Pediatr Nephrol 22, 84–90 (2007). https://doi.org/10.1007/s00467-006-0300-6

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  • DOI: https://doi.org/10.1007/s00467-006-0300-6

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