Remimazolam Infusion in Kidney Transplant Patients: A Multicenter Study

"This is the first clinical trial evaluating Remimazolam's pharmacokinetics (PK), pharmacodynamics (PD), and safety in renal transplant recipients-a population with unique physiological alterations due to end-stage renal disease and graft reperfusion. Key differentiators include:~Population-Specific Dosing Protocol:~Induction: 6 mg/kg/h until MOAA/S ≤1 (vs. 5-12 mg/kg/h in general surgery).~Maintenance: Titrated (0.5-2 mg/kg/h) to Narcotrend Index 27-60 (lower than typical BIS 40-60 targets), accounting for altered drug metabolism post-transplant.~Transplant-Specific Context:~Administered alongside standard immunosuppressants (methylprednisolone 750 mg + furosemide 60 mg at reperfusion) but prohibits common sedatives (midazolam/propofol) to isolate Remimazolam's effects.~PK/PD sampling accounts for graft function dynamics (e.g., blood draws during reperfusion and post-op days 1-6).~Exploratory Genetic Analysis:~First study linking VDR/"