TY  - JOUR
AB  - Tacrolimus (Tac) is a part of the standard immunosuppressive regimen after renal transplantation (RTx). However, its metabolism rate is highly variable. A fast Tac metabolism rate, defined by the Tac blood trough concentration (C) divided by the daily dose (D), is associated with inferior renal function after RTx. Therefore, we hypothesize that the Tac metabolism rate impacts patient and graft survival after RTx. We analyzed all patients who received a RTx between January 2007 and December 2012 and were initially treated with an immunosuppressive regimen containing Tac (Prograf®), mycophenolate mofetil, prednisolone and induction therapy. Patients with a Tac C/D ratio <1.05 ng/mL × 1/mg at three months after RTx were characterized as fast metabolizers and those with a C/D ratio ≥1.05 ng/mL × 1/mg as slow metabolizers. Five-year patient and overall graft survival were noticeably reduced in fast metabolizers. Further, fast metabolizers showed a faster decline of eGFR (estimated glomerular filtration rate) within five years after RTx and a higher rejection rate compared to slow metabolizers. Calculation of the Tac C/D ratio three months after RTx may assist physicians in their daily clinical routine to identify Tac-treated patients at risk for the development of inferior graft function, acute rejections, or even higher mortality.
AU  - Schütte-Nütgen, Katharina
AU  - Thölking, Gerold Bernhard
AU  - Steinke, Julia
AU  - Pavenstädt, Hermann-Joseph
AU  - Schmidt, René
AU  - Suwelack, Barbara
AU  - Reuter, Stefan Johannes
DA  - 2019-04-28
DO  - 10.3390/jcm8050587
KW  - kidney transplantation
KW  - tacrolimus
KW  - C/D-ratio
KW  - pharmacokinetics
LA  - eng
N1  - Journal of Clinical Medicine 8 (2019) 5, 587, 1-15
N1  - Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).
N1  - Eine Korrektur dieses Artikels befindet sich in: Journal of Clinical Medicine 8 (2019) 11, 1870
PY  - 2019-04-28
TI  - Fast Tac Metabolizers at Risk—It is Time for a C/D Ratio Calculation
UR  - https://nbn-resolving.org/urn:nbn:de:hbz:6-02129393408
Y2  - 2024-11-22T00:08:26
ER  -