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Related Concept Videos

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...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
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...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...

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Impact of Prior Adverse Pregnancy Outcome on Kidney Structure and Function in Kidney Donors.

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Elevations in Donor-Derived Cell-Free DNA and Allograft Outcomes in Kidney Transplantation.

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Related Experiment Video

Updated: Jun 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

Leflunomide in renal transplantation.

W James Chon1, Michelle A Josephson

  • 1Section of Nephrology, Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 5100, Chicago, IL 60637, USA.

Expert Review of Clinical Immunology
|May 21, 2011
PubMed
Summary

Leflunomide shows promise for managing viral infections like cytomegalovirus and BK virus in transplant patients. Careful monitoring is crucial due to potential side effects, but it may aid in reducing immunosuppression.

Area of Science:

  • Immunology
  • Pharmacology
  • Transplantation Medicine

Background:

  • Leflunomide, an isoxazole derivative, has immunosuppressive and antiviral properties.
  • Its FDA-approved use is for rheumatoid arthritis, but off-label applications are emerging.
  • Clinical and animal data suggest potential benefits in managing specific post-transplant complications.

Purpose of the Study:

  • To evaluate the potential role of leflunomide in specific transplant scenarios.
  • To explore its utility in reducing immunosuppression for resistant viral infections.
  • To assess its applicability in managing chronic allograft dysfunction.

Main Methods:

  • Review of accumulating clinical experience.
  • Analysis of relevant animal study data.

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Renal Subcapsular Transplantation of 2'-Deoxyguanosine-Treated Murine Embryonic Thymus in Nude Mice
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Published on: July 19, 2019

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation
11:49

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation

Published on: May 2, 2013

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Last Updated: Jun 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

Renal Subcapsular Transplantation of 2'-Deoxyguanosine-Treated Murine Embryonic Thymus in Nude Mice
07:39

Renal Subcapsular Transplantation of 2'-Deoxyguanosine-Treated Murine Embryonic Thymus in Nude Mice

Published on: July 19, 2019

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation
11:49

Trans-vivo Delayed Type Hypersensitivity Assay for Antigen Specific Regulation

Published on: May 2, 2013

  • Assessment of potential risks and benefits in transplantation.

    • Main Results:

    • Leflunomide is considered for reducing immunosuppression in resistant cytomegalovirus or BK virus infections.
    • It may be an option for renal transplant recipients with chronic allograft dysfunction.
    • Concerns regarding hepatotoxicity and hemolytic anemia necessitate caution.

    Conclusions:

    • Careful use of leflunomide under monitoring may help patients reduce immunosuppression during viral eradication.
    • It offers a potential strategy for managing specific post-transplant complications.
    • Current evidence does not support its use as a first-line agent over mycophenolate mofetil or sirolimus.