Correlation of cyclosporine A blood concentration with kidney injury for pediatric patients after hematopoietic stem cell transplantation: a retrospective cohort study.
Background: The potential nephrotoxicity of cyclosporine A (CsA) has been a problem for treating graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the relationship between CsA blood concentration and acute kidney injury (AKI) in pediatric...
| Publicado en: | European Journal of Clinical Pharmacology Vol. 81; no. 3; pp. 395 - 402 |
|---|---|
| Autores principales: | , , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Mar2025
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=183079871&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 183079871 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00316970 NP9 jtl: European Journal of Clinical Pharmacology issn: 00316970 maglogo: N pubinfo: dt: Mar2025 vid: 81 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 183079871 182090228 183079871 183079871 10.1007/s00228-024-03792-5 183079871 ppf: 395 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Correlation of cyclosporine A blood concentration with kidney injury for pediatric patients after hematopoietic stem cell transplantation: a retrospective cohort study. aug: au: Shi, Wei Qiu, Xin Huang, Liang Zeng, Linan Lu, Runxin Li, Hailong Zou, Kun Jia, Zhijun Cheng, Guo Yu, Qin Zhao, Limei Zhang, Lingli affil: NMPA Key Laboratory for Technical Research On Drug Products In Vitro and In Vivo Correlation, 610041, Chengdu, China sug: subj: Hematopoietic Stem Cell Transplantation Allogeneic Cells Cyclosporine Adverse Effects Cyclosporine Blood Kidney Failure, Acute Risk Factors Risk Assessment Pediatric Care Human Funding Source Male Female Child, Preschool Child Retrospective Design Record Review Prospective Studies Graft Versus Host Disease Nephrotoxicity Child, Preschool: 2-5 years Child: 6-12 years Male Female ab: Background: The potential nephrotoxicity of cyclosporine A (CsA) has been a problem for treating graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the relationship between CsA blood concentration and acute kidney injury (AKI) in pediatric patients after allo-HSCT remains unclear. Methods: We performed a retrospective study including pediatric patients who received allo-HSCT in West China Second Hospital of Sichuan University from 2000 to 2022 and collected their clinical data. Included patients' CsA blood concentration were divided into three cohorts according to the guideline. Multivariate logistic regression was used to estimate the relationship between AKI and CsA blood concentration and other factors. And the maximum cut-off value for the safe blood concentration range of CsA was obtained by the receiver operating characteristic (ROC) curve. Results: Seventy-nine patients (average age 6.75 ± 4.25) were included. The incidence of kidney injury for three CsA blood concentration cohorts (< 200 ng/ml, 200–300 ng/ml, > 300 ng/ml) were 21.30%, 23.50%, and 66.70%, respectively. A multivariate logistic regression identified CsA blood concentration (> 300 ng/ml) and infection were risk factors for AKI (OR <200 ng/ml: 0.115, 95% CI: 0.029–0.458; OR 200–300 ng/ml: 0.184, 95% CI: 0.036–0.929; OR infection: 5.006, 95% CI: 1.491–16.810). Meanwhile, the maximum cut-off value for the safe blood concentration range of CsA is 276.85 ng/ml with an AUC value of 0.684 (P = 0.010). Conclusion: In conclusion, clinical treatment for the pediatric patients after allo-HSCT may be considered to control the blood concentration of CsA in 200–276.85 ng/ml and closely monitoring patients who have infections. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|