Priyatharsini Vellingiri, Sriram Krishnamurthy, Rajan Sundaram, Suganthi S Ramachandran
{"title":"影响特发性肾病综合征患儿环孢素谷和给药后2小时浓度的因素。","authors":"Priyatharsini Vellingiri, Sriram Krishnamurthy, Rajan Sundaram, Suganthi S Ramachandran","doi":"10.1007/s13312-025-00177-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine the cyclosporine trough (C<sub>0</sub>) and two-hour post-dose concentrations (C<sub>2</sub>) in children with nephrotic syndrome (NS) and study the factors influencing them.</p><p><strong>Methods: </strong>In this ambispective cohort study, children with NS (including frequently relapsing, steroid-dependent and steroid-resistant nephrotic syndrome) on cyclosporine therapy were enrolled. Clinical and laboratory data were recorded. C<sub>0</sub> and C<sub>2</sub> were estimated using liquid chromatography mass spectrometry.</p><p><strong>Results: </strong>Among 27 patients with a mean (SD) age of 6.4 (4.1) years, the median (Q1, Q3) of C<sub>0</sub> and C<sub>2</sub> were 114.8 (86.1, 186.3) ng/mL and 661.6 (442.1, 884.6) ng/mL, respectively. At a mean (SD) cyclosporine dose of 4.1 (0.8) mg/kg/day, 12 (44%) patients had C<sub>0</sub> above and 4 (15%) below the therapeutic range (80-120 ng/mL). C<sub>2</sub> levels were outside the recommended ranges in 17 (63%) children, within range in 7 (26%), and below in 3 (11%). Capsule users had higher C<sub>0</sub> than syrup users. Amlodipine therapy was associated with higher C<sub>0</sub> levels.</p><p><strong>Conclusion: </strong>Nearly half the children had C<sub>0</sub> and C<sub>2</sub> levels outside the therapeutic range. Dosage form and amlodipine influenced C<sub>0</sub>, not C<sub>2</sub> concentrations.</p>","PeriodicalId":13291,"journal":{"name":"Indian pediatrics","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Influencing Cyclosporine Trough and Two-Hour Post-dose Concentrations in Children with Idiopathic Nephrotic Syndrome.\",\"authors\":\"Priyatharsini Vellingiri, Sriram Krishnamurthy, Rajan Sundaram, Suganthi S Ramachandran\",\"doi\":\"10.1007/s13312-025-00177-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine the cyclosporine trough (C<sub>0</sub>) and two-hour post-dose concentrations (C<sub>2</sub>) in children with nephrotic syndrome (NS) and study the factors influencing them.</p><p><strong>Methods: </strong>In this ambispective cohort study, children with NS (including frequently relapsing, steroid-dependent and steroid-resistant nephrotic syndrome) on cyclosporine therapy were enrolled. Clinical and laboratory data were recorded. C<sub>0</sub> and C<sub>2</sub> were estimated using liquid chromatography mass spectrometry.</p><p><strong>Results: </strong>Among 27 patients with a mean (SD) age of 6.4 (4.1) years, the median (Q1, Q3) of C<sub>0</sub> and C<sub>2</sub> were 114.8 (86.1, 186.3) ng/mL and 661.6 (442.1, 884.6) ng/mL, respectively. At a mean (SD) cyclosporine dose of 4.1 (0.8) mg/kg/day, 12 (44%) patients had C<sub>0</sub> above and 4 (15%) below the therapeutic range (80-120 ng/mL). C<sub>2</sub> levels were outside the recommended ranges in 17 (63%) children, within range in 7 (26%), and below in 3 (11%). Capsule users had higher C<sub>0</sub> than syrup users. Amlodipine therapy was associated with higher C<sub>0</sub> levels.</p><p><strong>Conclusion: </strong>Nearly half the children had C<sub>0</sub> and C<sub>2</sub> levels outside the therapeutic range. Dosage form and amlodipine influenced C<sub>0</sub>, not C<sub>2</sub> concentrations.</p>\",\"PeriodicalId\":13291,\"journal\":{\"name\":\"Indian pediatrics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-09-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13312-025-00177-4\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13312-025-00177-4","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Factors Influencing Cyclosporine Trough and Two-Hour Post-dose Concentrations in Children with Idiopathic Nephrotic Syndrome.
Objective: To determine the cyclosporine trough (C0) and two-hour post-dose concentrations (C2) in children with nephrotic syndrome (NS) and study the factors influencing them.
Methods: In this ambispective cohort study, children with NS (including frequently relapsing, steroid-dependent and steroid-resistant nephrotic syndrome) on cyclosporine therapy were enrolled. Clinical and laboratory data were recorded. C0 and C2 were estimated using liquid chromatography mass spectrometry.
Results: Among 27 patients with a mean (SD) age of 6.4 (4.1) years, the median (Q1, Q3) of C0 and C2 were 114.8 (86.1, 186.3) ng/mL and 661.6 (442.1, 884.6) ng/mL, respectively. At a mean (SD) cyclosporine dose of 4.1 (0.8) mg/kg/day, 12 (44%) patients had C0 above and 4 (15%) below the therapeutic range (80-120 ng/mL). C2 levels were outside the recommended ranges in 17 (63%) children, within range in 7 (26%), and below in 3 (11%). Capsule users had higher C0 than syrup users. Amlodipine therapy was associated with higher C0 levels.
Conclusion: Nearly half the children had C0 and C2 levels outside the therapeutic range. Dosage form and amlodipine influenced C0, not C2 concentrations.
期刊介绍：
The general objective of Indian Pediatrics is "To promote the science and practice of Pediatrics." An important guiding principle has been the simultaneous need to inform, educate and entertain the target audience. The specific key objectives are:
-To publish original, relevant, well researched peer reviewed articles on issues related to child health.
-To provide continuing education to support informed clinical decisions and research.
-To foster responsible and balanced debate on controversial issues that affect child health, including non-clinical areas such as medical education, ethics, law, environment and economics.
-To achieve the highest level of ethical medical journalism and to produce a publication that is timely, credible and enjoyable to read.
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