Monitoring of mycophenolic acid and kidney function during combined immunosuppressive therapy

Anna V. Oláh, László Asztalos, Gergely Ivády, Éva Varga, Ágota M. Kovács, János Kappelmayer, József Varga

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Mycophenolic acid (MPA), a selective inhibitor of lymphocyte proliferation, has lately been used to improve renal function and prolong graft survival in renal transplanted patients. Still, there is no consensus considering the recommended dosing and the therapeutic range of MPA. Methods: To estimate the safe therapeutic range of MPA, its plasma level and indicators of kidney function were measured in 216 patients (138 male, 78 female, age 46±12 years) 67±46 months after transplantation. Besides MPA, patients received cyclosporine (Group A, n=122) or tacrolimus (Group B, n=77). Seventeen patients (Group C) were treated with MPA in combination with everolimus or sirolimus. Plasma MPA was measured by enzyme inhibition assay. Results: In the whole study group MPA level increased with the dose of MPA (p=0.013). MPA level was below the therapeutic range in 40% (Group A) and 45% (Group B) of patients, respectively. MPA was 1.9±1.56 mg/L in Group A, 2.4±1.69 mg/L in Group B. In Group A MPA level increased and cyclosporine decreased with the progress of renal disease. Conclusions: Increasing MPA/cyclosporine ratio at more severe stages of chronic kidney disease was tolerable for the patients and rejection could be avoided. Tubular damage detected by urinary N-acetyl-β-D-glucosaminidase did not correlate with the MPA level.

Original languageEnglish
Pages (from-to)1849-1853
Number of pages5
JournalClinical Chemistry and Laboratory Medicine
Volume49
Issue number11
DOIs
Publication statusPublished - Nov 1 2011

Keywords

  • Cyclosporine
  • Estimated glomerular filtration rate (eGFR)
  • Kidney transplantation
  • Mycophenolic acid
  • N-acetyl-β-D-glucosaminidase
  • Therapeutic range

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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