Study on Precision Dosing Strategies of Anti-infective Agents in the Very Early Stage of Kidney Transplantation
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 40
- 主要终点
- In vivo exposure of anti-infective agents
研究概览
简要总结
This study addresses the clinical problem that reliance on serum creatinine, eGFR or empirical dosing fails to accurately adjust anti-infective doses given rapid renal function shifts within the very early 0-5 days post kidney transplantation. We will systematically analyze dynamic trajectories of renal biomarkers (serum creatinine, cystatin C, urine output and other renal function indices), quantify their quantitative associations with the exposure, clearance and pharmacodynamic target attainment of anti-infectives. Combined with clinical profiles, medication data, TDM results and perioperative factors, a population PK/PD model will be built for patients in the very early post-transplant stage. We will further validate the value of dynamic renal markers for individualized anti-infective dosing. This research provides evidence for shifting from static renal function-based empirical dosing to precision dosing guided by real-time renal changes and drug exposure, supporting optimized anti-infective dosage, enhanced efficacy and medication safety in early kidney transplant recipients.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged >= 18 years old;
- •Patients receiving kidney transplantation within 0-5 days postoperatively;
- •Clinically planned administration of anti-infective agents for perioperative prophylaxis, empirical therapy or confirmed infection treatment, with an anticipated treatment duration of no less than 5 days;
- •Written informed consent obtained from the subject or legal surrogate;
- •Indwelling urinary catheter retained for at least 48 hours postoperatively to facilitate early urine sample collection;
- •Patients anticipated to be free of dialysis requirement with urine output or early graft functional recovery at enrollment.
排除标准
- •Previous kidney transplantation or combined multi-organ transplantation
- •Patients requiring continuous renal replacement therapy in the early postoperative period
- •Severe hepatic dysfunction, defined as Child-Pugh class C, or ALT/AST > 5 times the upper limit of normal accompanied by markedly elevated bilirubin
- •Early postoperative use of ECMO, plasmapheresis or other extracorporeal therapies that substantially alter drug clearance
- •Pregnancy or lactation
- •Subjects judged inappropriate for enrollment by investigators, including those with unfeasible sampling, extremely short expected survival, severe missing clinical data, etc.
结局指标
主要结局
In vivo exposure of anti-infective agents
时间窗: Before and after each anti-infective administration within 0-5 days after kidney transplantation
次要结局
- Conventional renal function markers (Scr, eGFR)(Daily monitoring within 0-5 days post-transplantation)