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Prednisolone Disposition in Cushingoid and Noncushingoid Kidney Transplant Patients^*

Transplant Service, Department of Surgery, and the Division of Clinical Pharmacy, Department of Pharmacy, University of California San Francisco, California 94143

Address all correspondence and requests for reprints to: William J. C. Amend, Jr., M.D., Transplant Service, 884 Moffitt Hospital, University of California, San Francisco, California 94143.

Little information is available on the disposition of prednisolone in kidney transplant patients and whether correlations exist between the pharmacokinetics and therapeutic or toxic effects of this drug. The present study was designed to determine the pharmacokinetics of prednisolone in six non-cushingoid and six cushingoid transplant recipients. The elimination half-lives were not significantly different in the non-cushingoid and cushingoid patients (2.8 us. 3.3 h). However, other pharmacokinetic parameters were significantly lower in the cushingoid group: plasma clearance (147 us. 82 ml/min) and volume of distribution (32 us. 20 liters). In addition, the availability of prednisolone after oral prednisone administration was considerably variable (overall range, 27–108%) and was not significantly different between the two groups. Thus, in kidney transplant patients it appears that the plasma clearance and volume of distribution of prednisolone may distinguish between noncushingoid and cushingoid patients.

^* Presented in part at the annual meeting of the American Federation for Clinical Research, Washington, D.C., May 5–7, 1979.

Received January 14, 1980.

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