Evaluation of renal function in transplant patients on tacrolimus therapy.
Glomerular filtration rate (GFR), as measured by 24-hour creatinine clearance and clearance of iothalamate, and effective renal plasma flow (ERPF), as measured by the clearance of para-aminohippuric acid (PAH), were evaluated at 2 weeks, 1 month, and 3 months after transplantation in 8 renal transplant patients and at 1 month and 1 year after transplantation in 9 liver transplant patients receiving tacrolimus (Prograf) therapy. In renal transplant patients, there was a significant increase in GFR after transplantation. There was no change in GFR at 1 and 3 months as compared to 2 weeks after transplantation, while ERPF (ml/min/1.73 m2) was lower (p < 0.05) at 3 months (212+/-42) compared to 1 month (306+/-118) after transplantation. In liver transplant patients, GFR and ERPF were below normal despite normal serum creatinine concentrations, but there was no difference in GFR or ERPF at 1 month and 1 year after transplantation. Although below normal, renal function was well preserved in transplant patients while receiving chronic tacrolimus therapy over the study period. Dosage alterations ofrenally eliminated drugs may be required for drugs with a narrow therapeutic index.
Agarwala
Sangeeta
S
Department of Pharmaceutical Sciences and Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pennsylvania 15261, USA.
Culligan
Emma
E
Jain
Ashok
A
McCauley
Jerry
J
Shapiro
Ron
R
Chakrabarti
Pradip
P
Burckart
Gilbert
G
Venkataramanan
Raman
R
D000328:Adult; D000704:Analysis of Variance; D002851:Chromatography, High Pressure Liquid; D003287:Contrast Media; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics*; D007483:Iothalamic Acid; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D017596:Renal Plasma Flow, Effective; D016559:Tacrolimus / Q000493:pharmacokinetics*; D013997:Time Factors; D010130:p-Aminohippuric Acid
D003287:Contrast Media; D007166:Immunosuppressive Agents; D007483:Iothalamic Acid; D003404:Creatinine; D016559:Tacrolimus; D010130:p-Aminohippuric Acid