ArticlePediatric nephrology (Berlin, Germany)2016
Developmental changes of MPA exposure in children.
Article in Pediatric nephrology (Berlin, Germany), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Population pharmacokinetics of total and free mycophenolic acid in plasma in paediatric patients with nephrotic syndrome including salivary concentrations and the pharmacodynamics.Pharmacological reports : PR · 2026Article
- Plasma-saliva correlations for total and unbound mycophenolic acid and its glucuronide in children with nephrotic syndrome.Pediatric nephrology (Berlin, Germany) · 2026Article
- Recent Advances in Therapeutic Drug Monitoring of Voriconazole, Mycophenolic Acid, and Vancomycin: A Literature Review of Pediatric Studies.Pharmaceutics · 2021Review
- Long-term outcome of Japanese children with complicated minimal change nephrotic syndrome treated with mycophenolate mofetil after cyclosporine.Pediatric nephrology (Berlin, Germany) · 2019Article
- Does Vitamin D Affect Chronic Renal Allograft Function in Pediatric Transplant Patients?Annals of transplantation · 2018Article
- Mycophenolate mofetil-related leukopenia in children and young adults following kidney transplantation: Influence of genes and drugs.Pediatric transplantation · 2017Article
- Population pharmacokinetics and Bayesian estimation of mycophenolic acid concentrations in Chinese adult renal transplant recipients.Acta pharmacologica Sinica · 2017Article
- Ten-year treatment with mycophenolate mofetil using therapeutic drug monitoring for childhood-onset lupus nephritis in Japan.Pediatric nephrology (Berlin, Germany) · 2017Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDevelopmental changes (ontogeny) of drug disposition of Mycophenolate mofetil (MMF) have been understudied.
methodsThe charts of 37 pediatric renal transplant recipients (median age 7.3 years, median follow-up 7.8 (IQR 6.6, 14.3 years) who had regular mycophenolic acid (MPA) trough level monitoring in combination with tacrolimus (n = 31) or sirolimus (n = 6) therapy were analyzed retrospectively for their dose-normalized MPA exposure, steroid dose, albumin, hematocrit, and cystatin C estimated glomerular filtration rate (eGFR). Using appropriate univariate and multivariate methods, we determined whether MPA exposure was age dependent when controlling for the confounders.
resultsDose-normalized MPA trough levels could be calculated in 2,128 (median 45/patient) instances. Spearman rank correlation analysis revealed that age correlated with dose-normalized MPA trough level for both body weight and body surface area, as well as serum albumin, hematocrit, steroid dose, and eGFR. In the multivariate analysis, serum albumin and steroid dose were not significant, and hematocrit only being significant when the youngest group of patients < 6 years of age was compared. eGFR was the most important confounder, but age dependency remained significant when controlling for all confounders.
conclusionsSmall children are at a significantly greater risk for low MPA trough levels than adolescents, highlighting the need for pharmacokinetic monitoring of MPA.
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