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Related Concept Videos

Bioequivalence studies: Biowaivers01:13

Bioequivalence studies: Biowaivers

In certain scenarios, in vitro dissolution tests can replace in vivo bioequivalence studies. This is particularly true when a drug product, though available in varying strengths, maintains proportional similarity in its active and inactive ingredients. In such cases, the need for in vivo bioequivalence studies for lower strength variants may be waived, provided dissolution tests and in vivo studies on the highest strength yield satisfactory results.Bioequivalence can be indicated through...
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...
Renal Failure: Dose Adjustments01:11

Renal Failure: Dose Adjustments

In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Renal Drug Clearance: Overview01:06

Renal Drug Clearance: Overview

Renal clearance is a crucial parameter in pharmacokinetics that quantifies the rate at which the kidneys excrete a drug. It represents a constant fraction of the central volume of distribution containing the drug that the kidney eliminates per unit of time.
Renal clearance can be calculated using different methods. One approach is to divide the urinary drug excretion rate by the plasma drug concentration. This method directly measures renal clearance, indicating the kidneys' efficiency in...

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Related Experiment Video

Updated: Jul 1, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Sirolimus conversion experience in a single center.

H-H Wang1, J-Y Huang, S-H Chu

  • 1Department of Urology, Chang-Gung Memorial Hospital, Taoyuan, Taiwan.

Transplantation Proceedings
|September 16, 2008
PubMed
Summary
This summary is machine-generated.

Converting kidney transplant patients with chronic allograft nephropathy from calcineurin inhibitors to sirolimus improved graft function in 45% of cases. Early conversion in select patients may offer better outcomes.

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Last Updated: Jul 1, 2026

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

Surgical Angiogenesis in Porcine Tibial Allotransplantation: A New Large Animal Bone Vascularized Composite Allotransplantation Model
10:31

Surgical Angiogenesis in Porcine Tibial Allotransplantation: A New Large Animal Bone Vascularized Composite Allotransplantation Model

Published on: August 13, 2017

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Pharmacology

Background:

  • Chronic allograft nephropathy (CAN) is a primary cause of kidney graft loss.
  • Calcineurin inhibitors (CNIs) are frequently implicated in the development of CAN.
  • Switching immunosuppression strategies may mitigate CNI-related nephrotoxicity.

Purpose of the Study:

  • To evaluate the efficacy of converting from CNIs to sirolimus in kidney transplant recipients with CAN.
  • To identify predictors of successful sirolimus conversion for improved graft function.

Main Methods:

  • A cohort of 28 kidney transplant recipients with CAN were switched from CNIs to sirolimus.
  • Sirolimus was initiated at 2 mg/day with gradual CNI reduction, maintaining trough levels of 5-8 ng/mL.
  • Mycophenolic acid dose was halved; prednisolone remained unchanged.

Main Results:

  • 45% (12/27) of patients demonstrated improved kidney graft function post-conversion.
  • Common adverse events included anemia, hyperlipidemia, and pneumonitis.
  • Baseline serum creatinine < 2.2 mg/dL predicted a positive response to sirolimus.

Conclusions:

  • Sirolimus conversion can improve graft function in a significant portion of kidney transplant recipients with CAN.
  • Early conversion, particularly in patients with serum creatinine < 2.2 mg/dL, no proteinuria, and no hyperlipidemia, may be beneficial.