[Pharmacokinetics of cyclosporin A in patients with nephrotic syndrome].
The pharmacokinetics of Cy A have been studied in patients with N.S.. Eight patients (7 M, 1 F) received a single 12.5 mg/kg oral dose and a single 4 mg/kg intravenous dose. Plasma was separated from red blood cells at 22 degrees C, at least 2 hr after drawing. Cy A plasma levels were determined by reverse HPLC. The comparison of our pharmacokinetic parameters for the oral route with those from reference patients showed significant differences for T1/2 Ka and Tmax which were decreased in N.S. For the I.V. route we found a decrease in total plasma clearance (CLTP). Absolute bioavailability (18%) was also diminished. Moreover total cholesterol and B apolipoprotein were increased in our nephrotic population. Cy A is highly bound to lipoprotein and we found a significant negative correlation between CLTP of Cy A and either B apolipoprotein or total cholesterol. We conclude that the increase of lipoprotein in N.S. is probably responsible of the modifications in pharmacokinetics of Cy A. Nevertheless Cy A dosage can be not modified in N.S. when oral route is used and divided by a factor two for the I.V. route.
Moulin
B
B
Service de néphrologie, CHU Rouen, Hôpital de Bois-Guillaume.
Vernillet
L
L
Dadoun
C
C
Le Bigot
J F
JF
Godin
M
M
Fillastre
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001055:Apolipoproteins B / Q000097:blood; D002784:Cholesterol / Q000097:blood; D002851:Chromatography, High Pressure Liquid; D003524:Cyclosporins / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000097:blood / Q000378:metabolism*
D001055:Apolipoproteins B; D003524:Cyclosporins; D002784:Cholesterol
Pharmacocinétique de la ciclosporine A chez les patients atteints de syndrome néphrotique.