scholarly journals Evidence of Different Pharmacokinetics Including Relationship among AUC, Peak, and Trough Levels between Cyclosporine and Tacrolimus in Renal Transplant Recipients Using New Pharmacokinetic Parameter—Why Cyclosporine Is Monitored by C2 Level and Tacrolimus by Trough Level—

2008 ◽  
Vol 31 (1) ◽  
pp. 90-94 ◽  
Author(s):  
Hironori Takeuchi ◽  
Naoto Matsuno ◽  
Kayoko Senuma ◽  
Toshihiko Hirano ◽  
Takayoshi Yokoyama ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Pharmacokinetic Parameter ◽  
Trough Level ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Trough Levels

scholarly journals Acute kidney injury in renal transplant recipients undergoing cardiac surgery

2020 ◽  
Vol 36 (1) ◽  
pp. 185-196
Author(s):  
Gregory L Hundemer ◽  
Anand Srivastava ◽  
Kirolos A Jacob ◽  
Neeraja Krishnasamudram ◽  
Salman Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Renal Transplant ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Trough Levels

Abstract Background Acute kidney injury (AKI) is a key risk factor for chronic kidney disease in the general population, but has not been investigated in detail among renal transplant recipients (RTRs). We investigated the incidence, severity and risk factors for AKI following cardiac surgery among RTRs compared with non-RTRs with otherwise similar clinical characteristics. Methods We conducted a retrospective cohort study of RTRs (n = 83) and non-RTRs (n = 83) who underwent cardiac surgery at two major academic medical centers. Non-RTRs were matched 1:1 to RTRs by age, preoperative (preop) estimated glomerular filtration rate and type of cardiac surgery. We defined AKI according to Kidney Disease: Improving Global Outcomes criteria. Results RTRs had a higher rate of AKI following cardiac surgery compared with non-RTRs [46% versus 28%; adjusted odds ratio 2.77 (95% confidence interval 1.36–5.64)]. Among RTRs, deceased donor (DD) versus living donor (LD) status, as well as higher versus lower preop calcineurin inhibitor (CNI) trough levels, were associated with higher rates of AKI (57% versus 33% among DD-RTRs versus LD-RTRs; P = 0.047; 73% versus 36% among RTRs with higher versus lower CNI trough levels, P = 0.02). The combination of both risk factors (DD status and higher CNI trough level) had an additive effect (88% AKI incidence among patients with both risk factors versus 25% incidence among RTRs with neither risk factor, P = 0.004). Conclusions RTRs have a higher risk of AKI following cardiac surgery compared with non-RTRs with otherwise similar characteristics. Among RTRs, DD-RTRs and those with higher preop CNI trough levels are at the highest risk.

scholarly journals Supplementation with anti-oxidants Vitamin C and E decreases cyclosporine A trough-levels in renal transplant recipients

2005 ◽  
Vol 21 (1) ◽  
pp. 231-232 ◽  
Author(s):  
Aiko P. J. de Vries ◽  
Leendert H. Oterdoom ◽  
Rijk O. B. Gans ◽  
Stephan J. L. Bakker
Keyword(s):  
Renal Transplant ◽  
Vitamin C ◽  
Cyclosporine A ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Trough Levels

scholarly journals Glucose Metabolism in Renal Transplant Recipients on Tacrolimus: The Effect of Steroid Withdrawal and Tacrolimus Trough Level Reduction

2002 ◽  
Vol 13 (1) ◽  
pp. 221-227
Author(s):  
Johannes M. M. Boots ◽  
Elly M. van Duijnhoven ◽  
Maarten H. L. Christiaans ◽  
Bruce H. R. Wolffenbuttel ◽  
Johannes P. van Hooff
Keyword(s):  
Renal Transplant ◽  
Trough Level ◽  
Renal Transplant Recipients ◽  
Pancreatic Β Cell ◽  
Steroid Withdrawal ◽  
Transplant Recipients ◽  
Cell Secretion ◽  
Β Cell ◽  
C Peptide ◽  
Level Reduction

ABSTRACT. The relative role of steroids and tacrolimus in the development of glucose metabolic disorders and hyperlipidemia after renal transplantation has not yet been clearly established. Therefore, glucose metabolism was prospectively evaluated by intravenous glucose tolerance test, as was lipid profile, in fifteen white nondiabetic renal transplant recipients three times: before and after steroid withdrawal and after tacrolimus trough level reduction. After withdrawal of 10 mg of prednisolone, insulin resistance decreased (fasting C-peptide, 0.99 to 0.77 nmol/L [P < 0.0009]; fasting insulin, 9.5 to 8.1 mU/L [P = 0.09]; insulin/glucose ratio, 1.85 to 1.45 mU/mmol [P = 0.10]) and lipid levels decreased (total cholesterol, 5.1 to 4.2 mmol/L [P = 0.006]); HDL cholesterol, 1.4 to 1.1 mmol/L [P = 0.01]; LDL cholesterol, 3.0 to 2.5 mmol/L [P = 0.15]; triglycerides, 1.52 to 0.91 mmol/L [P = 0.02]). After tacrolimus trough level reduction from 9.5 to 6.4 ng/ml, pancreatic β-cell secretion capacity improved (C-peptide secretion increased from 49.0 to 66.6 nmol × min/L [P = 0.04] and insulin secretion increased from 1134 to 1403 mU × min/L [P = 0.06]). HbA1c improved also, from 5.9 to 5.3% (P = 0.002). Lipids did not change. In conclusion, steroid withdrawal resulted in a decrease in insulin resistance and a reduction in lipids, and tacrolimus trough level reduction resulted in an improved pancreatic β-cell secretion capacity. Therefore, these therapeutic measurements may contribute to the reduction of the cardiovascular morbidity and mortality in renal transplant recipients.

Cyclosporine A: peak or trough level monitoring in renal transplant recipients?

2001 ◽  
Vol 33 (7-8) ◽  
pp. 3122-3123 ◽  
Author(s):  
R. Wacke ◽  
B. Drewelow ◽  
G. Kundt ◽  
E.-M. Hehl ◽  
R. Bast ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Cyclosporine A ◽  
Trough Level ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Level Monitoring ◽  
Trough Level Monitoring

Clinically Significant Drug−Drug Interaction Between Tacrolimus and Phenobarbital

2010 ◽  
Vol 23 (6) ◽  
pp. 585-589 ◽  
Author(s):  
Nida Siddiqi ◽  
Kwaku Marfo
Keyword(s):  
Drug Interaction ◽  
Renal Transplant ◽  
Drug Interactions ◽  
Transplant Rejection ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Patient Identification ◽  
Clinically Significant ◽  
Trough Levels ◽  
Renal Transplant Rejection

Purpose: The case of a 57-year-old male who experienced acute renal transplant rejection due to subtherapeutic tacrolimus levels as a result of drug interaction with phenobarbital. Summary: Drug interactions with tacrolimus due to its metabolism through the CYP 450 3A4 enzymatic pathway have led to several reports of altered tacrolimus levels, which can lead to acute rejection in renal transplant recipients. We describe the case of a 57-year-old male initiated on immunosuppressive therapy with tacrolimus in addition to his anticonvulsant medications. Conclusion: Upon tacrolimus dose increases, discontinuation of carbamazepine, and minimization of phenobarbital dose, effective tacrolimus trough levels were achieved in our patient. Identification and elimination of such drug−drug interactions is necessary to assure adequate immunosuppression in renal transplant recipients.

scholarly journals SP810THE ASSOCIATION OF BODYWEIGHT AND CYP3A5 GENOTYPE WITH TACROLIMUS TROUGH LEVEL IN CHINESE RENAL TRANSPLANT RECIPIENTS

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii415-iii416
Author(s):  
Jang-Tao Tang ◽  
Yun-Ying Shi ◽  
Yi Li ◽  
Lin Yan ◽  
Ting-Li Wang ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Trough Level ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Cyp3a5 Genotype

189 CYCLOSPORIN TROUGH LEVELS CORRELATE WITH SERUM LIPOPROTEINS AND APOLIPOPROTEINS IN RENAL TRANSPLANT RECIPIENTS

1995 ◽  
Vol 17 (4) ◽  
pp. 430 ◽  
Author(s):  
N von Ahsen ◽  
V W Armstrong ◽  
M Helmhold ◽  
E Schütz ◽  
T Eisenhauer ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Serum Lipoproteins ◽  
Trough Levels
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