Please use this identifier to cite or link to this item:
10.3390/biomedicines12051125
Title: | The Influence of Tacrolimus Exposure and Metabolism on the Outcomes of Kidney Transplants |
Authors: | Maslauskiene, Rima Vaiciuniene, Ruta Radzeviciene, Aurelija Tretjakovs, Pēteris Gersone, Gita Stankevicius, Edgaras Bumblyte, Inga Arune Department of Human Physiology and Biochemistry |
Keywords: | C/D ratio;kidney injury molecule-1;kidney transplantation;neutrophil gelatinase-associated lipocalin;tacrolimus coefficient of variation;tacrolimus monitoring;3.1 Basic medicine;1.1. Scientific article indexed in Web of Science and/or Scopus database;Medicine (miscellaneous);General Biochemistry,Genetics and Molecular Biology |
Issue Date: | May-2024 |
Citation: | Maslauskiene , R , Vaiciuniene , R , Radzeviciene , A , Tretjakovs , P , Gersone , G , Stankevicius , E & Bumblyte , I A 2024 , ' The Influence of Tacrolimus Exposure and Metabolism on the Outcomes of Kidney Transplants ' , Biomedicines , vol. 12 , no. 5 , 1125 . https://doi.org/10.3390/biomedicines12051125 |
Abstract: | Tacrolimus (TAC) has a narrow therapeutic window and patient-specific pharmacokinetic variability. In our study, we analyzed the association between TAC exposure, metabolism, and kidney graft outcomes (function, rejection, and histological lesions). TAC trough (C0), coefficient of variation (TAC CV), concentration/dose ratio (C/D), and biomarkers related to kidney injury molecule-1 (KIM-1) and neutrophil gelatinase lipocalin (NGAL) were analyzed. We examined 174 patients who were subjected to a triple immunosuppressive regimen and underwent kidney transplantation between 2017 and 2022. Surveillance biopsies were performed at the time of kidney implantation and at three and twelve months after transplantation. We classified patients based on their Tac C/D ratios, classifying them as fast (C/D ratio < 1.05 ng/mL × 1/mg) or slow (C/D ratio ≥ 1.05 ng/mL × 1/mg) metabolizers. TAC exposure/metabolism did not significantly correlate with interstitial fibrosis/tubular atrophy (IF/TA) progression during the first year after kidney transplantation. TAC CV third tertile was associated with a higher chronicity score at one-year biopsy. TAC C/D ratio at three months and Tac C0 at six months were associated with rejection during the first year after transplantation. A fast TAC metabolism at six months was associated with reduced kidney graft function one year (OR: 2.141, 95% CI: 1.044–4.389, p = 0.038) and two years after transplantation (OR: 4.654, 95% CI: 1.197–18.097, p = 0.026), and TAC CV was associated with reduced eGFR at three years. uNGAL correlated with IF/TA and chronicity scores at three months and negatively correlated with TAC C0 and C/D at three months and one year. Conclusion: Calculating the C/D ratio at three and six months after transplantation may help to identify patients at risk of suffering acute rejection and deterioration of graft function. |
Description: | Publisher Copyright: © 2024 by the authors. |
DOI: | 10.3390/biomedicines12051125 |
ISSN: | 2227-9059 |
Appears in Collections: | Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure |
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