title: Long-term outcome of ketoconazole and tacrolimus co-administration in kidney transplant patients.
abstract: OBJECTIVE
  To study the long-term outcome of ketoconazole and tacrolimus combination in kidney transplant recipients.
  
  
  METHODS
  From 2006 to 2010, ketoconazole was given in 199 patients and was continued for at least 1 year or until graft failure (Group 1), while 149 patients did not receive any ketoconazole (Group 2). A combination of tacrolimus, mycophenolate and steroid was used as maintenance therapy. High risk patients received basiliximab induction.
  
  
  RESULTS
  Basic demographic data was similar between the 2 groups. The 5-year cumulative incidence of biopsy-confirmed and clinically-treated acute rejection was significantly higher in Group 1 than in Group 2 (34% vs 18%, P = 0.01). The 5-year Kaplan-Meier estimated graft survival (74.3% vs 76.4%, P = 0.58) and patient survival (87.8% vs 87.5%, P = 0.93) were not different between the 2 groups. Multivariable analyses identified ketoconazole usage as an independent risk of acute rejection (HR = 2.33, 95%CI: 1.33-4.07; P = 0.003) while tacrolimus dose in the 2(nd) month was protective (HR = 0.89, 95%CI: 0.75-0.96; P = 0.041).
  
  
  CONCLUSIONS
  Co-administration of ketoconazole and tacrolimus is associated with significantly higher incidence of acute rejection in kidney transplant recipients.
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Enver
authors.initials: E
authors.lastname: Khan
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Mary
authors.initials: M
authors.lastname: Killackey
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Damodar
authors.initials: D
authors.lastname: Kumbala
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Heather
authors.initials: H
authors.lastname: LaGuardia
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Liu
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Huai-Zhen
authors.initials: HZ
authors.lastname: Qin
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Brent
authors.initials: B
authors.lastname: Alper
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Anil
authors.initials: A
authors.lastname: Paramesh
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Joseph
authors.initials: J
authors.lastname: Buell
authors.affiliation: Enver Khan, Mary Killackey, Damodar Kumbala, Heather LaGuardia, Yong-Jun Liu, Huai-Zhen Qin, Brent Alper, Anil Paramesh, Joseph Buell, Rubin Zhang, Section of Nephrology, Department of Medicine, New Orleans, LA 70112, United States.
authors.forename: Rubin
authors.initials: R
authors.lastname: Zhang
keywords: Cytochrome P450; Kidney transplant; Pharmacokinetics; Rejection; Survival; Tacrolimus Ketoconazole