| Co-Investigator(Kenkyū-buntansha) |
TANIGAWA Yusuke Keio University, Department of Medicine, Professor, 医学部, 教授 (30179832)
ASANO Koichiro Keio University, Department of Medicine, Assistant Professor (60192944)
山口 佳寿博 慶應義塾大学, 医学部, 助教授 (30129712)
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| Budget Amount *help |
¥3,600,000 (Direct Cost: ¥3,600,000)
Fiscal Year 2004: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 2003: ¥2,600,000 (Direct Cost: ¥2,600,000)
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| Research Abstract |
Cystatin C(Cys C), a new endogenous marker of renal function, is believed to be superior to serum creatinine(Scr) or calculated creatinine clearance(Ccr) as an indicator of renal function. Although serum Cys C is one of the most predominant candidates in the estimation of renal function, there are few reports applying serum Cys C to the dosage adjustment of renally excreted drugs such as vancomycin(VCM), teicoplanin(TEIC) and carboplatin. We compared retrospectively the usefulness of cystatin C with that of Ccr in the prediction of total clearance(CLtot) of VCM, TEIC and carboplatin, in advance of the investigation whether serum Cys C concentration is a better marker in the prediction of dosing regimen than calculated Ccr. Age, body weight(BW), 5cr, BUN, Ccr, and Cys C is distributed widely. Good correlation was shown between 5cr and Cys C. Calculated Ccr also correlated significantly with 1/Cys C. Both 1/Cys C adjusted by BW and calculated Ccr correlated significantly with TEIC CLtot. Our results clearly demonstrated that CLtot of VCM and TEIC correlated well with 1/Cys C adjusted by BW. Furthermore, the correlation coefficients in the case of 1/Cys C adjusted by BW were higher than those in the case of the Ccr calculated by the Cockcroft-Gault formula. The results in this study enable us to predict the CLtot of VCM and TEIC using the regression equation as shown below. The similar results were obtained in carboplatin CL. Patients with abnormally low Scr, fluctuated Scr, and severe infection, and elderly patients may have a benefit when accurate estimate of the CLtot is quickly needed for the determination of optimal dosage regimen. Furthermore, Cys C is expected to be clinically useful to estimate CLtot of the other drugs excreted mainly by the kidney. Our study suggested effective strategy to optimize dosage regimen of those agents.
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