Tacrolimus trough levels in kidney transplant recipients

BMC Nephrology

Young Hui Hwang¹  Jaeseok Yang²  Hyunjung Kim³  Kyungok Min⁴ 

[1] Department of Nursing, College of Medicine, University of Ulsan, Ulsan, South Korea;Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea;Divison of Nursing & Research Institute of Nursing Science, Hallym University, 1 Hallymdaehak-gil, 24252, Chuncheon, Gangwon-do, South Korea;Transplant Center, Department of Nursing, Seoul National University Hospital, Seoul, South Korea;

关键词: Coefficient of variation;    Mean;    Medication adherence;    Standard deviation;    Tacrolimus trough level;   

DOI  :  10.1186/s12882-021-02622-5

来源: Springer

【 摘 要 】

BackgroundIt is very important that kidney transplant recipients (KTRs) take immunosuppressive drugs to prevent graft rejection. This study aimed to identify the tacrolimus trough levels (TTL)-mean, TTL-standard deviation (SD), and TTL- coefficient of variation (CV) as well as factors affecting these values over a 2-year period in clinically stable patients > 5 years after kidney transplantation (KT).MethodsThis retrospective study analyzed data from 248 adult outpatients > 5 years after KT. Medical chart data, including TTL, graft rejection, and tacrolimus dose change during a 2-year period, between January 2017 and December 2018, were collected. Multivariable regression analyses were conducted to determine the factors influencing the TTL-mean, TTL-SD, and TTL-CV.ResultsThe TTL-mean, TTL-SD, and TTL-CV were 6.00 ± 1.07 ng/mL, 1.51 ± 1.09 ng/mL, and 0.25 ± 0.14, respectively. The TTL-mean, TTL-SD, and TTL-CV did not differ according to sex, type of donor, retransplant, pretransplant kidney disease, body mass index, or posttransplant time; hence, they are stable in kidney transplant recipients > 5 years after KT. The higher the TTL-mean, the higher the TTL-SD. Age and the TTL-SD significantly predicted the TTL-mean (p < .001). Tacrolimus dose change and the TTL-mean significantly predicted the TTL-SD (p < .001). Tacrolimus dose change significantly predicted the TTL-CV (p = .008).ConclusionIn clinically stable KTRs, TTL-SD and TTL-CV change sensitively in relation to tacrolimus dose changes. Therefore, changes in TTL-SD and TTL-CV in stable KTRs with no tacrolimus dose change require medical interest and attention.

【 授权许可】

CC BY