Maja Nowicka1, Monika Górska1, Zuzanna Nowicka1,2, Krzysztof Edyko1, Piotr Edyko3, Sebastian Wiślicki4, Anna Zawiasa-Bryszewska1,5, Janusz Strzelczyk6, Józef Matych3, Ilona Kurnatowska7,8. 1. Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland. 2. Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland. 3. Department of Urology and Kidney Transplantation, N Pirogov Provincial Specialist Hospital, Lodz, Poland. 4. Clinical Department of Anesthesiology and Intensive Care and Pain Management, University Clinical Hospital No 1 N Barlicki in Lodz, Lodz, Poland. 5. Department of Nephrology, University Clinical Hospital No 1 N Barlicki in Lodz, Lodz, Poland. 6. Department of General and Transplant Surgery, Medical University of Lodz, Lodz, Poland. 7. Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland, ilona.kurnatowska@umed.lodz.pl. 8. Department of Nephrology, University Clinical Hospital No 1 N Barlicki in Lodz, Lodz, Poland, ilona.kurnatowska@umed.lodz.pl.
Abstract
INTRODUCTION: Tacrolimus (TAC) metabolism rate has the potential to impact graft function after kidney transplantation (KTx). We aimed to analyze the relationship between the early post-KTx TAC C/D ratio (blood trough concentration normalized by total daily dose) and kidney graft function in a 2-year follow-up. METHODS: We retrospectively analyzed data from 101 post-KTx patients at 3, 6, 12, and 24 months after KTx to identify the C/D ratio cutoff value optimal for dividing patients into fast and slow TAC metabolizers. We investigated the relationship between their TAC metabolism rate and graft function. RESULTS: Patients were divided based on the TAC C/D ratio at 6 months after KTx of 1.47 ng/mL * 1 mg. Fast metabolizers (C/D ratio <1.47 ng/mL * 1 mg) presented with significantly worse graft function throughout the whole study period (p < 0.05 at each timepoint) and were significantly less likely to develop good graft function (estimated glomerular filtration rate ≥45 mL/min/1.73 m2) than slow metabolizers. Our model based on donor and recipient age, recipient sex and slow/fast metabolism status allowed for identification of patients with compromised graft function in 2-year follow-up with 66.7% sensitivity and 94.6% specificity. CONCLUSION: Estimating TAC C/D ratio at 6 months post-KTx might help identify patients at risk of developing deteriorated graft function in a 2-year follow-up.
INTRODUCTION:Tacrolimus (TAC) metabolism rate has the potential to impact graft function after kidney transplantation (KTx). We aimed to analyze the relationship between the early post-KTx TAC C/D ratio (blood trough concentration normalized by total daily dose) and kidney graft function in a 2-year follow-up. METHODS: We retrospectively analyzed data from 101 post-KTx patients at 3, 6, 12, and 24 months after KTx to identify the C/D ratio cutoff value optimal for dividing patients into fast and slow TAC metabolizers. We investigated the relationship between their TAC metabolism rate and graft function. RESULTS:Patients were divided based on the TAC C/D ratio at 6 months after KTx of 1.47 ng/mL * 1 mg. Fast metabolizers (C/D ratio <1.47 ng/mL * 1 mg) presented with significantly worse graft function throughout the whole study period (p < 0.05 at each timepoint) and were significantly less likely to develop good graft function (estimated glomerular filtration rate ≥45 mL/min/1.73 m2) than slow metabolizers. Our model based on donor and recipient age, recipient sex and slow/fast metabolism status allowed for identification of patients with compromised graft function in 2-year follow-up with 66.7% sensitivity and 94.6% specificity. CONCLUSION: Estimating TAC C/D ratio at 6 months post-KTx might help identify patients at risk of developing deteriorated graft function in a 2-year follow-up.
Authors: Gerold Thölking; Katharina Schütte-Nütgen; Julia Schmitz; Alexandros Rovas; Maximilian Dahmen; Joachim Bautz; Ulrich Jehn; Hermann Pavenstädt; Barbara Heitplatz; Veerle Van Marck; Barbara Suwelack; Stefan Reuter Journal: J Clin Med Date: 2019-10-02 Impact factor: 4.241
Authors: Gerold Thölking; Nils Hendrik Gillhaus; Katharina Schütte-Nütgen; Hermann Pavenstädt; Raphael Koch; Barbara Suwelack; Stefan Reuter Journal: J Clin Med Date: 2020-01-23 Impact factor: 4.241