title: Effect of different tacrolimus levels on early outcomes after kidney transplantation.
abstract: BACKGROUND
  There is a paucity of modern data on the impact of high tacrolimus levels early after kidney transplantation.
  
  
  METHODS
  This study analyzed the impact of various trough levels of tacrolimus in the first 2 weeks post-transplant on rates of delayed graft function (DGF), length of stay (LoS), hyperkalemia, hyperglycemia, and biopsy-proven acute rejection (BPAR) rates in the first 3 months post-transplant in a retrospective single-center cohort of patients. Patients were divided into 4 groups based on the average of two highest 12-hour trough tacrolimus levels: <10 ng/mL, 10-12 ng/mL, 12-15 ng/mL, >15 ng/mL.
  
  
  RESULTS
  The incidence of DGF was noted to be significantly higher in the <10 ng/mL, >15 ng/mL and the 12-15 ng/mL tacrolimus groups as compared to the 10-12 ng/mL group (49%, 25% and 4%, respectively, p≤0.0001). Mean LoS was also noted to be significantly higher in the >15 ng/mL tacrolimus group as compared to the 10-12 ng/mL group (7.4 days and 6.1 days respectively, p=0.0007). There was no difference in the rates of hyperkalemia, hyperglycemia or BPAR.
  
  
  CONCLUSIONS
  This is a modern confirmation of the association between higher tacrolimus levels early after kidney transplantation and increased rate of DGF and increased LoS.
authors: Division of Nephrology, Hypertension & Renal Transplantation, Department of Medicine, University of Florida, Gainesville, USA.
authors: Shehzad
authors: S
authors: Rehman
authors: Division of Nephrology, Hypertension & Renal Transplantation, Department of Medicine, University of Florida, Gainesville, USA.
authors: Xuerong
authors: X
authors: Wen
authors: Division of Nephrology, Hypertension & Renal Transplantation, Department of Medicine, University of Florida, Gainesville, USA.
authors: Michael J
authors: MJ
authors: Casey
authors: Division of Nephrology, Hypertension & Renal Transplantation, Department of Medicine, University of Florida, Gainesville, USA.
authors: Alfonso H
authors: AH
authors: Santos
authors: Division of Transplantation Surgery, Department of Surgery, University of Florida, Gainesville, USA.
authors: Kenneth
authors: K
authors: Andreoni
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D051799:Delayed Graft Function / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006084:Graft Rejection / Q000188:drug therapy* / Q000453:epidemiology; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D015994:Incidence; D016030:Kidney Transplantation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus