TY  - JOUR
AB  - The effective calcineurin inhibitor (CNI) tacrolimus (Tac) is an integral part of the standard immunosuppressive regimen after renal transplantation (RTx). However, as a potent CNI it has nephrotoxic potential leading to impaired renal function in some cases. Therefore, it is of high clinical impact to identify factors which can predict who is endangered to develop CNI toxicity. We hypothesized that the Tac metabolism rate expressed as the blood concentration normalized by the dose (C/D ratio) is such a simple predictor. Therefore, we analyzed the impact of the C/D ratio on kidney function after RTx. Renal function was analyzed 1, 2, 3, 6, 12 and 24 months after RTx in 248 patients with an immunosuppressive regimen including basiliximab, tacrolimus, mycophenolate mofetil and prednisolone. According to keep the approach simple, patients were split into three C/D groups: fast, intermediate and slow metabolizers. Notably, compared with slow metabolizers fast metabolizers of Tac showed significantly lower estimated glomerular filtration rate (eGFR) values at all the time points analyzed. Moreover, fast metabolizers underwent more indication renal biopsies (p = 0.006) which revealed a higher incidence of CNI nephrotoxicity (p = 0.015) and BK nephropathy (p = 0.024) in this group. We herein identified the C/D ratio as an easy calculable risk factor for the development of CNI nephrotoxicity and BK nephropathy after RTx. We propose that the simple C/D ratio should be taken into account early in patient’s risk management strategies.
AU  - Thölking, Gerold Bernhard
AU  - Fortmann, Christian
AU  - Fortmann, Christian Patrick
AU  - Koch, Raphael
AU  - Gerth, Hans Ulrich
AU  - Gerth, Hans Ulrich Volker
AU  - Gerth, Hans U.
AU  - Pabst, Dirk
AU  - Pavenstädt, Hermann-Joseph
AU  - Kabar, Iyad
AU  - Hüsing, Anna Katharina Elisabeth Pia
AU  - Wolters, Heiner
AU  - Wolters, Heiner Huber
AU  - Reuter, Stefan Johannes
AU  - Suwelack, Barbara
DA  - 2014-10-23
DO  - doi:10.1371/journal.pone.0111128
LA  - eng
N1  - PLoS ONE 9 (2014) 10, 1-8, e111128
N1  - Finanziert durch den Open-Access-Publikationsfonds 2014/2015 der Deutschen Forschungsgemeinschaft (DFG) und der Westfälischen Wilhelms-Universität Münster (WWU Münster).
PY  - 2014-10-23
SN  - 1932-6203
TI  - The Tacrolimus Metabolism Rate Influences Renal Function after Kidney Transplantation
UR  - https://nbn-resolving.org/urn:nbn:de:hbz:6-81319476425
Y2  - 2024-12-03T17:26:43
ER  -