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Therapeutic drug monitoring in childhood idiopathic nephrotic syndrome: a state of the art review

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Abstract

Immunosuppressants are commonly used as steroid-sparing agents in childhood idiopathic nephrotic syndrome (NS) to induce and sustain remissions. These drugs have narrow therapeutic indices with high inter- and intra-patient variability. Therapeutic drug monitoring (TDM) would therefore be essential to guide the prescription. Multiple factors in NS contribute to additional variability in drug concentrations, especially during relapses. In this article, we review the currently available evidence of TDM in NS and suggest a practical approach for clinicians’ reference.

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Authors and Affiliations

  1. Department of Pharmacy, Hong Kong Children’s Hospital, Kowloon City, Hong Kong

    Fiona Fung-yee Lai

  2. Paediatric Nephrology Centre, Hong Kong Children’s Hospital, Kowloon City, Hong Kong

    Fiona Fung-yee Lai, Eugene Yu-hin Chan & Alison Lap-tak Ma

  3. Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Trust, London, UK

    Kjell Tullus

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Lai, F.Fy., Chan, E.Yh., Tullus, K. et al. Therapeutic drug monitoring in childhood idiopathic nephrotic syndrome: a state of the art review. Pediatr Nephrol 39, 85–103 (2024). https://doi.org/10.1007/s00467-023-05974-2

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