Pharmacokinetics of mycophenolic acid in kidney transplant recipients treated with a low dose (1 gram/day) of mycophenolate mofetil.

Pharmacokinetic studies of mycophenolic acid (MPA) were performed in 16 stable Thai kidney transplant recipients treated with 1 g/d of mycophenolate mofetil (MMF). The complete area under the blood concentration-time curve (AUC) of MPA was determined using the linear trapezoidal rule from 8 concentrations at, 0, 1, 2, 3, 4, 6, 8, and 12 h after MMF administration. The mean values of AUC(0-12) were 37.54 + 0.80 microg x h/ml. MPA concentrations at 8 h after dosing, not the trough or maximum levels, showed the best correlation with AUC(0-12) (r2 = 0.72). The equation model of abbreviated AUC of MPA, derived by multiple linear regression analysis, that had the highest correlation (r2) and lowest absolute prediction error (APE) was: AUC = 0.6 C1 + 1.9 C3 + 8.68 C8 + 4.65 (r2 = 0.92, APE = 2.05 +/- 0.32%). The best abbreviated AUC equations obtained by linear trapezoidal rule were: AUC = 4.5 C0 + C1 + 1.5 C2 + 5 C4 (r2 = 0.78, APE = 5.78 +/- 1.14%) and AUC = 5 C0 + C1 + C2 + 5 C3 (r2 = 0.76, APE = 6.21 +/- 1.46%).

Situation of laboratory service and instruments in Thailand: a descriptive study from questionnaires.

Laboratory instruments are one of the main items in laboratory investment. To establish data for the situation of laboratory service and instruments in Thailand, questionnaires were randomly sent to one hundred and twenty laboratories. Sixty-three filled questionnaires from eleven university and affiliated hospitals, thirty-four government hospitals, and eighteen private hospital laboratories were sent back to the authors to be analyzed. Only the number of samples and instruments used during office hours were analyzed in this study by descriptive method. From the data it was found that the average number of personnel and tests of the university and affiliated hospital laboratories was the highest. To analyze the efficiency of the instruments used in the laboratories, the authors compared the average service number of samples or tests to the average number of samples or tests that was calculated from the instruments. The ratio of the average number of samples or tests that were calculated from the instruments and the average service number of samples or tests for chemistry and CBC were 2.13, 3.41, 5.24 and 2.33, 2.76, 3.71 in university and affiliated hospital laboratories, government hospital laboratories, and the private hospital laboratories, respectively. From the data, it was concluded that the instrument situation in laboratories of the university and affiliated hospitals was more appropriate than government hospital and private hospital laboratories. To improve the efficiency of using laboratory instruments, more concern must be given to the management of laboratory instruments and cooperation between hospitals could increase the efficiency of the instrument investment.

The role of carbamylated hemoglobin in identifying acute and chronic renal failure.

Carbamylated hemoglobin (CarbHb) levels expressed as valipe hydantoin (VH) were measured by high performance liquid chromatography (HPLC) in patients with acute renal failure (ARF, n=35) and chronic renal failure (CRF, n=39). CarbHb levels in CRF patients were approximately 2.5 times of those in ARF ones (121.2 +/- 8 vs 54.8 +/- 6 microgVH/gHb, p<0.01). CarbHb levels of 80 microgVH/gHb provided the best statistical values (sensitivity of 89% and specificity of 82%). CarbHb/BUN and Carb/Cr ratios were also effective determinants in differentiation between ARF and CRF. CarbHb/BUN ratio of 1.5 and CarbHb/Cr ratio of 20 were the best statistical cut off points. As such, measurement of CarbHb levels could be a reliable non-invasive method in identifying ARF from CRF patients.