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NDT Advance Access originally published online on October 8, 2008
Nephrology Dialysis Transplantation 2009 24(1):21-27; doi:10.1093/ndt/gfn556
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Pharmacodynamic monitoring of calcineurin inhibitor therapy: Is there a clinical benefit?

Claudia Sommerer1, Thomas Giese2, Stefan Meuer2 and Martin Zeier1

1 Department of Nephrology, University Hospital, INF 162 2 Department of Immunology, University of Heidelberg, INF 400, D-69120 Heidelberg, Germany

Claudia Sommerer, Department of Nephrology, University of Heidelberg, Im Neuenheimer Feld 162, D-69120 Heidelberg, Germany. Tel: +49-6221-91120; Fax: +49-6221-9112990; E-mail: claudia.sommerer@med.uni-heidelberg.de

Keywords: calcineurin inhibitor; pharmacodynamic; renal transplantation; therapeutic drug monitoring

The first 150 words of the full text of this article appear below.



   Introduction
 
Immunosuppressive therapy should provide a maximum of efficacy with a minimum of toxicity. The introduction of the immunosuppressive calcineurin inhibitors (CNI) cyclosporine A (CsA) in the early 1980s and tacrolimus (Tac) in the 1990s improved renal allograft survival, especially by a reduction of the acute rejection rate in the first year after transplantation [1,2]. With the increased experience of CNIs, the early and long-term side effects such as nephrotoxicity [3,4], post-transplant cancer [5,6] and metabolic deteriorations appeared [7]. Although the CNIs are one of the pivotal immunosuppressive drugs in organ transplantation, there is still no consensus on the optimal therapeutic drug level of CsA and Tac in terms of their safety and efficacy. Among patients treated with comparable CNI doses and trough levels, there is a broad range covering acute rejection episodes at one end and symptoms of CNI side effects at . . . [Full Text of this Article]



   Pharmacokinetic (PK) monitoring of CNI therapy
 


   Pharmacodynamic (PD) monitoring of CNI therapy
 
Non-specific assays for PD monitoring
Specific assays for PD monitoring
Clinical data of specific PD monitoring


   Conclusions
 

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