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Research article:-
Vijay Ramegowdanapura Malleshappa1,Jayasheelan Mambally Rachaiah2* & Niranjan Mambally Rachaiah3
Affiliations:-
1MD (General Medicine)., DNB (Nephrology), Consultant Nephrologist, Apollo BGS Hospitals, Mysore, Karnataka, India.
2MD (Internal Medicine)., DNB., MNAMS, Assistant Professor, Department Of Medicine, Mysore Medical College & Research Institute, Mysore, Karnataka, India.
3MD (Internal Medicine)., DNB., MNAMS, Assistant Professor, Department Of Medicine, Hassan Institute of Medical Sciences, Hassan 573201 Karnataka, India.
Abstract:
Background: Tacrolimus is an immunosuppressive agent which improves clinical outcomes in kidney transplant recipients. The risk of tacrolimus nephrotoxicity was higher in patients with high systemic exposure of tacrolimus during the early post transplant period. Hence we made an effort to monitor tacrolimus levels and related nephrotoxicity.
Aims: To find out the incidence of tacrolimus nephrotoxicity and to correlate with tacrolimus levels.
Materials and Methods: A prospective cross sectional study. Tacrolimus levels were estimated and looked for nephrotoxicity by renal biopsy. Pearson’s Chi Square test was applied.
Results: Tacrolimus level estimations done on 135 recipients. The average mean level was 6.9±1.8 ng/ml. Early tacrolimus toxicity was diagnosed in two (22.2%) recipients, while most (4–44.4%) were in the 4–6 months follow-up period. More rejection seen in recipients having lower mean tacrolimus levels in the early (≤30days) post transplant period. Four (44.4%) patients with tacrolimus toxicity had acute rejection. During
30 days there were two events of toxicity among patients having mean level >10 ng/ml.
Conclusion:No significant correlation found between average tacrolimus trough levels and nephrotoxicity. However patients with nephrotoxicity had high tacrolimus trough levels just before the event. Hence nephrotoxicity cannot be predicted based on mean tacrolimus levels alone.
Key Words: Tacrolimus Nephrotoxicity, Renal Transplantation, Graft Rejection.
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Article citation:-
Vijay R M, Jayasheelan M R, Niranjan M R. A correlative study of tacrolimus levels with nephrotoxicity in post renal transplanted patients. Journal of pharmaceutical and biomedical sciences (J Pharm Biomed Sci.) 2013 June; 31(31): 1130-1136.
Copyright © 2013 Vijay R M, Jayasheelan M R & Niranjan M R. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.