Cystatin C for Therapeutic Drug Monitoring/Commentary/Commentary

Concentrations were fitted to a 1-compartment model using Bayesian analysis (PKS®, Abbott). Because the new estimated glomerular filtration (GFR)3 rate equations, such as Modification of Diet in Renal Disease- isotope dilution mass spectrometry (MDRD-IDMS) or CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration), are not included in the software, estimations for dose adjustment were carried out using the creatinine clearance (CrCl) calculated by the Cockcroft-Gault (CG) formula. [...]the patient also suffered from liver injury (Table 1). Because it has been proven that in advanced liver diseases or liver cirrhosis an overestimation of the GFR occurs when sCr is used, the measurement of serum cystatin C (CysC) was recommended to detect a possibly impaired renal function. [...]high amikacin predose concentrations cause nephrotoxicity and ototoxicity. Because amikacin has a narrow therapeutic range, it is believed that therapeutic drug monitoring is appropriate for amikacin therapy to ensure adequate concentrations and, therefore, drug efficacy and safety (1 ).