Cyclosporine Toxicity and Toxicokinetics Profiles in Renal Transplant Recipients
Journal of Clinical Toxicology
Cyclosporine is the backbone of immunosuppression in kidney transplantation. However, it leads to multiple toxic effects, most of which are dose-dependent. In this respect, the quality of renal functions is undoubtedly linked to cyclosporine drug levels. Objective: To evaluate the association among cyclosporine trough-peak levels, dosage and its toxic effects. Methods and materials: In 102 kidney transplant recipients, serum cyclosporine trough-peak levels, serum creatinine, blood urea, blood
... blood urea, blood urea and nitrogen, serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase were measured periodically from the beginning of May, 2011 until the end of July, 2012. The relationships among previous laboratory parameters were detected in relation to the prevalence of toxic cyclosporine effects. Results: Consequently, the patients are with renal transplantations; concentrations of cyclosporine trough that can get lowered safely towards the range of 150-200 ng/ml, added by minimal toxic cyclosporine effects without increased risk for graft rejection. Conclusion: The findings of this study showed the detrimental toxic effects of high cyclosporine concentrations and the efficiency of low cyclosporine trough/peak levels in maintaining of an efficient immunosuppressive effect plus a minimal toxic cyclosporine effects and positive therapeutic outcomes in the renal transplant patients. Cyclosporine was ordered frequently at the start of therapy, basis when trying to establish a dosing regimen. Once an appropriate dose has been determined, the level was tested less frequently and once every 1-3 months according to the current patient condition. The target blood cyclosporine trough-peak was (level from 150 to 200 ng/ml trough per 700 to 800 ng/ml peak) within the transplantation operation of the renal related patients and all over the postoperative transplantation course.