Immunosuppressants are commonly used as steroid-sparing agents in childhood idiopathic nephrotic syndrome (NS) to induce and sustain remissions. These drugs have narrow therapeutic indices with high inter- and intra-patient variability. Therapeutic drug monitoring (TDM) would therefore be essential to guide the prescription. Multiple factors in NS contribute to additional variability in drug concentrations, especially during relapses. In this article, we review the currently available evidence of TDM in NS and suggest a practical approach for clinicians' reference.
Keywords: Calcineurin inhibitor; Drug level; Mycophenolate mofetil; Nephrotic syndrome; Pharmacokinetics; Therapeutic drug monitoring.
© 2023. The Author(s), under exclusive licence to International Pediatric Nephrology Association.