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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Pharmacokinetics of Enoxaparin After Renal Transplantation in Pediatric Patients
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Pharmacokinetics of Enoxaparin After Renal Transplantation in Pediatric Patients

机译：儿科患者肾移植后烯脱蒿素的药代动力学

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摘要

Abstract Enoxaparin is commonly used in the prevention of renal allograft vascular thrombosis but off‐label in children, and no consensus exists regarding the optimal dosing and dose adjustment. In this retrospective study, 444 anti‐Xa levels were obtained from 30 pediatric renal transplant recipients in order to investigate enoxaparin population pharmacokinetics. The main results were (1) 25% of children achieved the target anti‐Xa activity 36?hours after initiation of treatment, (2) anti‐Xa time courses were best described by a 1‐compartment open model with first‐order absorption, (3) body weight but not renal function was the sole covariate influencing clearance and volume of distribution, and (4) large between‐subject and between‐occasion variabilities in anti‐Xa activity were observed. However, creatinine‐based estimated glomerular filtration rate in the first post–renal transplantation hours may not reliably reflect the actual renal function of the children. Based on the final population model, a Bayesian‐based program was developed in order to estimate the individual pharmacokinetic parameters on a single anti‐Xa measurement, allowing determination of the next enoxaparin dose that will quickly achieve an appropriate anti‐Xa activity (targeting 0.3‐0.5?IU/mL) and anticoagulation. Finally, these results should help standardize practices that remain to date largely heterogeneous in pediatric intensive care units.
机译：摘要烯诺素通常用于预防肾同种异体移植血管血栓形成，但在儿童中的标签，并且没有关于最佳给药和剂量调节的共识。在此回顾性研究中，从30个儿科肾移植受者获得444次抗XA水平，以调查亚诺帕林人口药代动力学。主要结果是（1）25％的儿童达到目标抗XA活动36？在启动后的时间抗XA活动，（2）抗XA时间课程最佳地描述了一堂开放模型，其中一级的一个吸收， （3）体重但不是肾功能是唯一的协变化影响和分布体积，并且观察到抗XA活性之间的受试者和场合可变性之间的大量影响。然而，在第一肾后移植时间中的基于肌酸酐的估计肾小球过滤速率可能无法可靠地反映儿童的实际肾功能。基于最终人口模型，开发了一种基于贝叶斯的计划，以估计单个抗XA测量的个体药代动力学参数，允许测定将迅速达到适当的抗XA活性的下一个脑胰岛素剂量（靶向0.3 -0.5？IU / ml）和抗凝。最后，这些结果应该有助于标准化待迄今为止在儿科密集型护理单位的基本异质的实践。

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