Risk factors for standard Tac-related nephrotoxicity in renal transplant recipients
10.3760/cma.j.issn.0254-1785.2011.09.004
- VernacularTitle:肾移植术后常规免疫抑制方案下发生他克莫司肾毒性的影响因素
- Author:
Yun MIAO
;
Lixin YU
;
Wenfeng DENG
;
Shaojie FU
;
Jian XU
;
Chuanfu DU
;
Yibin WANG
;
Guirong YE
;
Minjie ZHOU
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Tacrolimus;
Drug toxicity;
Kidney;
Risk factors
- From:
Chinese Journal of Organ Transplantation
2011;32(9):523-526
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the factors for standard TAC-related nephrotoxicity in renal transplant recipients. MethodsClinical data of 132 patients in TAC-based regiment with a dose of 0. 15-0.3 mg· kg-1 · day-1 and a trough level of 8-11 μg/L during first 2 years post renal transplantation, were retrospectively analyzed. TAC-related nephrotoxicity was diagnosed by renal biopsy and/or clinical criteria. All recipients were divided into 2 groups: TAC nephrotoxicity group (n = 25) and control group (n = 107). Logistic regression analysis was used to rank the relative risk of potential variables including age, gender, delayed graft function (DGF), drug exposure, duration of therapy,liver function, albumin level, hematocrit and gene polymorphism for CYP3A5 and MDR1.ResultsTAC-related nephrotoxicity was found in 25 (18. 9 ％ ) recipients. Univariate and Logistic regression analysis revealed that the influencing factors for TAC-related nephrotoxicity with a standard immunosuppressive regimen and a normal trough level range were identified as: abnormal liver function (RR = 3. 05,95 ％ CI 0. 879-11. 533, P = 0. 024), albumin level (RR = 0. 966,95 ％ CI 0. 994-1. 006, P = 0. 018 ), hematocrit ( RR = 0. 999, 95 ％ CI 0. 998-1. 000, P = 0. 032), CYP3A5 gene polymorphism (RR= 0. 777,95 ％ CI 0. 023-6. 798,P= 0. 032) ,and MDR1 gene polymorphism (RR=0. 654,95 ％ CI 0. 053-7. 109, P = 0. 017). ConclusionLiver function, albumin level, hematocrit, and gene polymorphism for CYP3A5and MDR1as well are influencing factors for TAC-related nephrotoxicity in renal transplant recipients with a standard immunosuppressive regimen and a normal trough level range,in which abnormal liver function is the most important adverse risk factor. These factors should be considered for better individual therapy in renal transplant recipients.
