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

Publication ,  Journal Article
Trachtman, H; Frymoyer, A; Lewandowski, A; Greenbaum, LA; Feig, DI; Gipson, DS; Warady, BA; Goebel, JW; Schwartz, GJ; Lewis, K; Anand, R ...
Published in: Clin Pharmacol Ther
July 2015

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

Duke Scholars

Published In

Clin Pharmacol Ther

DOI

EISSN

1532-6535

Publication Date

July 2015

Volume

98

Issue

1

Start / End Page

25 / 33

Location

United States

Related Subject Headings

  • Pharmacology & Pharmacy
  • Male
  • Lisinopril
  • Kidney Transplantation
  • Hypertension
  • Humans
  • Female
  • Child
  • Angiotensin-Converting Enzyme Inhibitors
  • Adolescent
 

Citation

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Trachtman, H., Frymoyer, A., Lewandowski, A., Greenbaum, L. A., Feig, D. I., Gipson, D. S., … Best Pharmaceuticals for Children Act-Pediatric Trials Network Administrative Core Committee, . (2015). Pharmacokinetics, Pharmacodynamics, and Safety of Lisinopril in Pediatric Kidney Transplant Patients: Implications for Starting Dose Selection. Clin Pharmacol Ther, 98(1), 25–33. https://doi.org/10.1002/cpt.127
Trachtman, H., A. Frymoyer, A. Lewandowski, L. A. Greenbaum, D. I. Feig, D. S. Gipson, B. A. Warady, et al. “Pharmacokinetics, Pharmacodynamics, and Safety of Lisinopril in Pediatric Kidney Transplant Patients: Implications for Starting Dose Selection.Clin Pharmacol Ther 98, no. 1 (July 2015): 25–33. https://doi.org/10.1002/cpt.127.
Trachtman H, Frymoyer A, Lewandowski A, Greenbaum LA, Feig DI, Gipson DS, et al. Pharmacokinetics, Pharmacodynamics, and Safety of Lisinopril in Pediatric Kidney Transplant Patients: Implications for Starting Dose Selection. Clin Pharmacol Ther. 2015 Jul;98(1):25–33.
Trachtman, H., et al. “Pharmacokinetics, Pharmacodynamics, and Safety of Lisinopril in Pediatric Kidney Transplant Patients: Implications for Starting Dose Selection.Clin Pharmacol Ther, vol. 98, no. 1, July 2015, pp. 25–33. Pubmed, doi:10.1002/cpt.127.
Trachtman H, Frymoyer A, Lewandowski A, Greenbaum LA, Feig DI, Gipson DS, Warady BA, Goebel JW, Schwartz GJ, Lewis K, Anand R, Patel UD, Best Pharmaceuticals for Children Act-Pediatric Trials Network Administrative Core Committee. Pharmacokinetics, Pharmacodynamics, and Safety of Lisinopril in Pediatric Kidney Transplant Patients: Implications for Starting Dose Selection. Clin Pharmacol Ther. 2015 Jul;98(1):25–33.
Journal cover image

Published In

Clin Pharmacol Ther

DOI

EISSN

1532-6535

Publication Date

July 2015

Volume

98

Issue

1

Start / End Page

25 / 33

Location

United States

Related Subject Headings

  • Pharmacology & Pharmacy
  • Male
  • Lisinopril
  • Kidney Transplantation
  • Hypertension
  • Humans
  • Female
  • Child
  • Angiotensin-Converting Enzyme Inhibitors
  • Adolescent