Cyclosporine disposition and long-term renal function in a 500-pound kidney transplant recipient.

Cyclosporine disposition and long-term renal function in a 500-pound kidney transplant recipient.

Flechner S M; Haug M; Fisher R K; Modlin C S

American journal of kidney diseases : the official journal of the National Kidney Foundation

1998

1998-10

Patient size has been suggested as a risk factor in kidney transplantation. We have followed a recipient of a cadaver kidney who became massively obese (232 kg, 511 lbs) 5 years posttransplantation. He has maintained stable renal function with no rejection episodes and at 5 years has a measured serum creatinine of 2.2 mg/dL, creatinine clearance 42 mL/min, and urinary protein excretion of 320 mg/24h. Both oral and intravenous cyclosporine (Sandimmune) pharmacokinetic studies were done on a steady-state dose of 150 mg, which represents 0.65 mg/kg per dose. The patient exhibited very high bioavailability, F = 95%, and an oral elimination T1/2 of over 21 hours. These data confirm that stable cyclosporine delivery in very obese recipients can be sustained by dosing normalized to the ideal body weight and trough level monitoring.

Biological Availability; Cadaver; Chronic/surgery; Cyclosporine/administration & dosage/*pharmacokinetics; Diabetes Mellitus; Diabetic Nephropathies/surgery; Humans; Immunosuppressive Agents/administration & dosage/*pharmacokinetics; Injections; Intravenous; Kidney Failure; Kidney Function Tests; Kidney Transplantation/*physiology; Male; Middle Aged; Morbid/etiology/*physiopathology; Obesity; Type 1/complications

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

E4–E4

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