Impact of mycophenolic acid dose modifications on renal function after kidney transplantation.
OBJECTIVE
Mycophenolic acid dose modifications after renal transplantation seem to adversely affect renal allograft outcome. The aim of this retrospective study was to examine the effect of mycophenolic acid dose modifications on renal function 1 year after transplantation and to determine the factors predictive of those dose modifications within the first year after renal transplantation.


METHODS
All 130 patients at our institution who were treated de novo between January 2002 and April 2003 with either a mycophenolate mofetil-based or an enteric-coated mycophenolate sodium-based therapy and who had a functioning renal allograft 1 month after transplantation were included in this study.


RESULTS
Fifty-seven patients (43.8%) underwent a dose modification during the first year after transplantation. One, 3, 6, and 12 months after transplantation, renal function was significantly improved in the patients who did not receive a dose modification. A mycophenolic acid dose that 1 year after transplantation was less than the initial dose received just after transplantation was an independent factor associated with deteriorating renal function. Sirolimus immunosuppression, Cytomegalovirus infection, and pretransplant lymphocyte counts were independent factors associated with mycophenolic acid dose modifications within the first year after kidney transplantation.


CONCLUSIONS
Modification of the mycophenolic acid dose may adversely affect renal function 1 year after transplantation.
Kamar
Nassim
N
Department of Nephrology, Dialysis and Multiorgan Transplantation, CHU Rangueil, Toulouse, France. kamar.n@chu-toulouse.fr
Oufroukhi
Loubna
L
Sallusto
Federico
F
Cointault
Olivier
O
Lavayssière
Laurence
L
Mouzin
Marc
M
Guitard
Joelle
J
Durand
Dominique
D
Rostaing
Lionel
L
D000328:Adult; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007239:Infections / Q000453:epidemiology; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000276:immunology* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000453:epidemiology / Q000821:virology; D012189:Retrospective Studies
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid