Role of prednisolone pharmacokinetics in postchallenge glycemia after renal transplantation

Therapeutic Drug Monitoring
Henrik Andreas BergremTrond Jenssen

Abstract

Prednisolone may cause hyperglycemia after organ transplantation. Even at comparable weight-adjusted doses, prednisolone side effects vary considerably between individuals, suggesting between-patient pharmacokinetic differences. In renal transplant patients, assessment of glucocorticoid diabetogenicity is confounded by calcineurin inhibitors (CNIs). The present study aimed to investigate, in a CNI-free setting, the association between exposure to unbound prednisolone and glucose tolerance in stable nondiabetic long-term renal transplant patients. An oral glucose tolerance test and a 12-hour prednisolone pharmacokinetic study were performed in 108 nondiabetic CNI-naive subjects (41 women and 67 men) treated with prednisolone (median 0.15 mg kg d, interquartile range 0.14-0.18 mg kg d) and azathioprine. The area under the curve (AUC) of unbound prednisolone was analyzed in multiple linear regression analysis with 120-minute postchallenge glucose AUC as the dependent variable. A high AUC of unbound serum prednisolone was independently associated with a high glucose AUC (P = 0.030). A high glucose AUC was also associated with a high patient age and triglyceride level (both P < or = 0.001). No correlation was observed between the da...Continue Reading

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Citations

Jun 10, 2011·European Journal of Clinical Pharmacology·Katherine A BarracloughChristine E Staatz
Sep 29, 2012·Clinical Pharmacokinetics·Troels K BergmannChristine E Staatz
Nov 4, 2011·Expert Opinion on Pharmacotherapy·Trond Jenssen, Anders Hartmann
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Aug 20, 2019·Therapeutic Drug Monitoring·Emily BrooksChristine E Staatz
Nov 13, 2020·Therapeutic Drug Monitoring·Ragnhild H SkaubyStein Bergan

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