1.Analysis of Influential Factors of Tacrolimus Blood Concentration in 104 Patients with Nephrotic Syndrome of Different Nationalities
Lili ZHU ; Yirui WANG ; Gang HAN ; Bosong CHEN ; Yuan YUAN ; Guoru CHEN ; Abudureyimu GULIMIRE ; Jun ZHAO
China Pharmacy 2019;30(15):2110-2114
OBJECTIVE: To investigate the influential factors of tacrolimus (TAC) blood concentration in patients with nephrotic syndrome (NS) of different nationalities. METHODS: In retrospective study, clinical information of 104 patients who diagnosed as NS and met inclusion/exclusion criteria were collected from the First Affiliated Hospital of Xinjiang Medical University during Dec. 2017 and Nov. 2018, including gender, age, ethnicity, height, body weight, laboratory test items, combined drug use and TAC dosage. Influential factors for TAC blood concentration were analyzed by SPSS 22.0 software, and effects of combined use of Wuzhi capsule on steady-state blood trough concentration ([ss][c min]) and dose of TAC were also analyzed. RESULTS: Among 104 patients, totally TAC blood concentration of 394 case times were monitored; using TAC standardized blood concentration as endpoint, Han nationality group was significantly lower than Uygur and Kazak nationality group (P=0.003); patients receiving combined use of Wuzhi capsule were significantly higher than those without combined use of Wuzhi capsule (P=0.056); the patients with combined use of calcium antagonists was significantly higher than the patients without calcium antagonists (P=0.01); the patients with combined use of proton pump inhibitors were significantly lower than those without combined proton pump inhibitors (P=0.01); patients with normal hematocrit were significantly lower than those with abnormal hematocrit (P=0.001); patients with normal urea nitrogen were significantly lower than those with abnormal urea nitrogen (P<0.001). The dose of TAC in patients receiving combined Wuzhi capsule were significantly lower than those without combined use of Wuzhi capsule (P=0.001), there was no significant difference in [ss][c min] of TAC between them (P=0.29). CONCLUSIONS: For NS patients, the effects of ethnicity, calcium antagonists, proton pump inhibitors, hematocrit, urea nitrogen and Wuzhi capsules on TAC blood concentration should be considered when TAC is used.