Number of Regularly Prescribed Drugs and Intrapatient Tacrolimus Trough Levels Variability in Stable Kidney Transplant Recipients
High intra-patient variability (IPV) of tacrolimus levels is associated with poor long-term outcome after transplantation. We aimed to evaluate whether the number of regularly prescribed medications is associated with the tacrolimus IPV. We have studied 152 kidney transplant recipients (KTRs) with m...
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doaj-8f039c4a63854b979107dd1c2f9320dc2020-11-25T03:17:18ZengMDPI AGJournal of Clinical Medicine2077-03832020-06-0191926192610.3390/jcm9061926Number of Regularly Prescribed Drugs and Intrapatient Tacrolimus Trough Levels Variability in Stable Kidney Transplant RecipientsPiotr Giza0Rafał Ficek1Tomasz Dwulit2Jerzy Chudek3Iwona Woźniak4Andrzej Więcek5Aureliusz Kolonko6Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, PolandDepartment of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, PolandDepartment of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, PolandDepartment of Internal Medicine and Oncological Chemotherapy, Medical University of Silesia, Reymonta 8, 40-027 Katowice, PolandUniversity Hospital, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, PolandDepartment of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, PolandDepartment of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Francuska 20/24, 40-027 Katowice, PolandHigh intra-patient variability (IPV) of tacrolimus levels is associated with poor long-term outcome after transplantation. We aimed to evaluate whether the number of regularly prescribed medications is associated with the tacrolimus IPV. We have studied 152 kidney transplant recipients (KTRs) with mean post-transplant time of 6.0 ± 3.1 years. The coefficient of variation (CV) as a measure of IPV was calculated in each individual patient. Data concerning the type and number of currently prescribed medications were collected. The participants were divided into four groups, based on the number of regularly prescribed drugs (≤3, 4–6, 7–9, ≥10 drugs, respectively). There was an increasing trend for median CV, proportional to the increasing number of medications [group 1: 0.11 (interquartile range, 0.08–0.14), group 2: 0.14 (0.01–0.17), group 3: 0.17 (0.14–0.23), group 4: 0.17 (0.15–0.30); <i>p</i> value for trend = 0.001]. Stepwise backward multivariate regression analysis revealed that the number of medications [partial correlation coefficient (<i>r</i><sub>partial</sub>) = 0.503, <i>p </i>< 0.001] independently influenced the tacrolimus IPV. Concomitant steroid or diuretics use increased IPV only in Advagraf-treated KTRs, whereas proton-pump inhibitor or statin use increased IPV in the Prograf group but not in the Advagraf group. A large number of concomitant medications significantly increases the tacrolimus IPV in stable KTRs.https://www.mdpi.com/2077-0383/9/6/1926chronic kidney diseasecoefficient of variationco-medicationdrug interactionsnumber of medicationsextended-release tacrolimus |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Piotr Giza Rafał Ficek Tomasz Dwulit Jerzy Chudek Iwona Woźniak Andrzej Więcek Aureliusz Kolonko |
spellingShingle |
Piotr Giza Rafał Ficek Tomasz Dwulit Jerzy Chudek Iwona Woźniak Andrzej Więcek Aureliusz Kolonko Number of Regularly Prescribed Drugs and Intrapatient Tacrolimus Trough Levels Variability in Stable Kidney Transplant Recipients Journal of Clinical Medicine chronic kidney disease coefficient of variation co-medication drug interactions number of medications extended-release tacrolimus |
author_facet |
Piotr Giza Rafał Ficek Tomasz Dwulit Jerzy Chudek Iwona Woźniak Andrzej Więcek Aureliusz Kolonko |
author_sort |
Piotr Giza |
title |
Number of Regularly Prescribed Drugs and Intrapatient Tacrolimus Trough Levels Variability in Stable Kidney Transplant Recipients |
title_short |
Number of Regularly Prescribed Drugs and Intrapatient Tacrolimus Trough Levels Variability in Stable Kidney Transplant Recipients |
title_full |
Number of Regularly Prescribed Drugs and Intrapatient Tacrolimus Trough Levels Variability in Stable Kidney Transplant Recipients |
title_fullStr |
Number of Regularly Prescribed Drugs and Intrapatient Tacrolimus Trough Levels Variability in Stable Kidney Transplant Recipients |
title_full_unstemmed |
Number of Regularly Prescribed Drugs and Intrapatient Tacrolimus Trough Levels Variability in Stable Kidney Transplant Recipients |
title_sort |
number of regularly prescribed drugs and intrapatient tacrolimus trough levels variability in stable kidney transplant recipients |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-06-01 |
description |
High intra-patient variability (IPV) of tacrolimus levels is associated with poor long-term outcome after transplantation. We aimed to evaluate whether the number of regularly prescribed medications is associated with the tacrolimus IPV. We have studied 152 kidney transplant recipients (KTRs) with mean post-transplant time of 6.0 ± 3.1 years. The coefficient of variation (CV) as a measure of IPV was calculated in each individual patient. Data concerning the type and number of currently prescribed medications were collected. The participants were divided into four groups, based on the number of regularly prescribed drugs (≤3, 4–6, 7–9, ≥10 drugs, respectively). There was an increasing trend for median CV, proportional to the increasing number of medications [group 1: 0.11 (interquartile range, 0.08–0.14), group 2: 0.14 (0.01–0.17), group 3: 0.17 (0.14–0.23), group 4: 0.17 (0.15–0.30); <i>p</i> value for trend = 0.001]. Stepwise backward multivariate regression analysis revealed that the number of medications [partial correlation coefficient (<i>r</i><sub>partial</sub>) = 0.503, <i>p </i>< 0.001] independently influenced the tacrolimus IPV. Concomitant steroid or diuretics use increased IPV only in Advagraf-treated KTRs, whereas proton-pump inhibitor or statin use increased IPV in the Prograf group but not in the Advagraf group. A large number of concomitant medications significantly increases the tacrolimus IPV in stable KTRs. |
topic |
chronic kidney disease coefficient of variation co-medication drug interactions number of medications extended-release tacrolimus |
url |
https://www.mdpi.com/2077-0383/9/6/1926 |
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