Pharmacokinetics, Pharmacodynamics, and Safety of Lisinopril in Pediatric Kidney Transplant Patients: Implications for Starting Dose Selection

摘要: Hypertension in pediatric kidney transplant recipients contributes to long-term graft loss, yet treatment options--including angiotensin-converting enzyme inhibitors--are poorly characterized this vulnerable population. We conducted a multicenter, open-label pharmacokinetic (PK) study of daily oral lisinopril 22 children (ages 7-17 years) with stable function. Standard noncompartmental PK analyses were performed at steady state. Effects on blood pressure examined lisinopril-naive patients (n = 13). Oral clearance declined proportion underlying function; however, low estimated glomerular filtration rate (30-59 ml/min per 1.73m(2)), exposure (standardized 0.1 mg/kg/day dose) was within the range reported previously without transplant. In patients, 85% and 77% had ≥ 6 mmHg reduction systolic diastolic pressure, respectively. Lisinopril well tolerated. Our provides initial insight use transplant, including starting dose considerations.