新規腎機能マーカーシスタチンCを応用した抗MRSA薬の投与設計

Abstract

An accurate estimate of the renal function is necessary for the precise therapeutic drug monitoring of anti-MRSA drugs such as vancomycin, arbekacin and teicoplanin, which are eliminated by the kidneys. In clinical practice, the measurement of endogenous serum substances in order to estimate the glomerular filtration rate (GFR) is commonly performed, and the serum creatinine concentration has become the most commonly used serum marker of renal function. However, the serum creatinine concentration is affected by age and gender. As a result, the measurement of serum creatinine concentration can lead to an overestimation of GFR, especially in the elderly. In recent years, it has been reported that the serum cystatin C concentration is not influenced by gender or age, so serum cystatin C concentration is a better marker of renal function than serum creatinine concentration. A recent meta-analysis demonstrated that the serum cystatin C concentration was a better renal function marker for detecting the GFR than the conventional measurement of the serum creatinine concentration, and several formula using the cystatin C concentration have also recently been reported to accurately estimate GFR. Recent studies have reported that the serum cystatin C concentration is a better marker of the clearance of drugs eliminated by the kidneys than the serum creatinine concentration. In this article, we review the application of cystatin C in the drug administration plan of anti-MRSA drugs.