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Background:The management of Steroid Resistant Nephrotic Syndrome (SRNS) is an uphill task for paediatric nephrologists as immunosuppressive agentsare the mainstay of treatment in these patients. Tacrolimus is used along with steroids.This study is conducted to see therelationship between the tacrolimus dose, drug level and response in the management of SRNS.Methods:This quasi experimental study wasconducted at The Children’s Hospital Lahore over a period of one year. Patients with SRNS of either sex and 1–10years of age were included and those withsecondary nephrotic syndrome were excluded. Tacrolimuswas given ata dose of 0.05–0.1 mg/kg/day in 2 divided doses along with steroids.The follow-up was done for six months with proteinuria monitoring and tacrolimus drug levels done two weeks afterinitiation of treatment. Results:Out of 42 patients, 27(64.3%) were males and 15(35.7%) were females. The most common histological diagnosis observed was mesangio-proliferative glomerulonephritis in 30(71.4%) patients. The tacrolimus trough level range was 0.5–15.20 ng/ml with a mean value of 4.68 ng/ml±2.85.Forty-one (97.6%) children showed complete response to treatment while one patient showed partial response.Conclusion:This study suggests that tacrolimus is an effective drug for treatment of SRNS in paediatric patients and there is no linear relationship between the drug dose, response and drug level.
Syed Sajid Hussain Shah,, Farkhanda Hafeez, , Naureen Akhtar. (2015) TACROLIMUS DRUG LEVEL AND RESPONSE TO TREATMENT IN IDIOPATHIC CHILDHOOD STEROID RESISTANT NEPHROTIC SYNDROME, JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD, Volume 27, Issue 4.
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