Background
The aim of the study was to assess whether the C2 level is a good parameter to predict a drug’s maximal concentration CMAX values in Egyptian kidney transplant recipients (KTR).
Methods
Fifty stable kidney transplant recipients (KTR) with a previously confirmed diagnosis of schistosomal infection compared to KTR (n = 50) without schistosomal infection regarding CsA concentrations at time 0 (trough), 1.5, 2, 2.5, 3, and 3.5 h post-CsA. Statistical significance of linear regression between different CsA time concentrations and drug dosages was calculated.
Results
Patients in schistosomal group, had significantly lower C2 levels (511 ± 118 ng/ml) compared with control group (669 ± 213 ng/ml) (P < 0.05), whereas C2.5 level was significantly higher (730 ± 215 and 527 ± 129 ng/ml, respectively; P < 0.05). Only C2.5 in schistosomal group had a significant linear regression relationship with both morning cyclosporine (CsA) dose and CsA dose expressed as mg/kg/day (P = 0.0123, r = 0.573018).
Conclusions
Egyptian patients have special characteristics in drug absorption and metabolism, mostly due to schistosomal infection, and they may need the use of C2.5 for monitoring of CsA. If confirmed by subsequent larger experience, these findings may have a significant impact on our management of CyA immunosuppression in clinical renal transplantation in certain ethnicities.