Correlation between Liver and Kidney Toxicity and Cyclosporin A Blood Concentration in 1236 Samples of Patients with Aplastic Anemia / 中国药师

ABSTRACT

Objective:To analyze the correlation between cyclosporin A blood concentration and drug-induced liver and kidney in-jury in the patients with aplastic anemia, investigate the significance of cyclosporin A concentration in the monitoring of liver and kidney toxicity, and provide theoretical basis for clinical individualized drug use. Methods:A total of 149 patients with aplastic anemia trea-ted with cyclosporin A as the main therapeutic drug were selected, and after 3-day treatment, the blood concentration of cyclosporin A was detected by an HPLC-UV method 10 minutes before the administration and 2 hours after the administration. The liver and kidney function were measured at the same time. The correlation between the different concentration of cyclosporine A and the change of liver and kidney function was analyzed. Results:All the patients were monitored cyclosporine A blood concentration with 1236 samples, and 34 patients (22. 82%) were with drug-induced liver injury and 51 patients (34. 23%) showed drug-induced kidney toxicity. The average C0 of liver injury patients was (297. 92 ± 74. 14) μg·L-1 , and C2 was (944. 47 ± 148. 47) μg·L-1 , while the average C0 of kidney injury patients was (311. 41 ± 52. 80)μg·L-1, and C2 was (926. 25 ± 136. 02) μg·L-1. The function indices of liver (ALT, AST, TBIL) and kidney (SC, BUN, UA) were significantly higher than those in the normal group (P<0. 05), and the blood concentration of cyclosporin A was significantly correlated with the liver,and kidney function. Conclusion:There is a certain correla-tion between cyclosporine A -induced toxicity and its blood concentration and C2 may be a more valuable predictor for drug -induced liver injury.