title: Conversion From Twice-Daily to Once-Daily Tacrolimus in Stable Kidney Graft Recipients.
abstract: BACKGROUND
  Immunosuppression has a pivotal role in kidney transplantation. The new prolonged-release formulation of tacrolimus was developed to provide a more convenient once-daily dosing to improve patient adherence.
  
  
  METHODS
  We selected 60 stable kidney transplant recipients who underwent tacrolimus conversion in our unit. Conversion was made on a 1 mg:1 mg basis in 66.7% of patients (n = 40) and on a 1 mg:1.1 mg basis in the remaining 33.3% (n = 20). Clinical and analytical data at conversion and postconversion was analyzed retrospectively to evaluate the efficacy and safety of conversion from tacrolimus twice-daily to once-daily formulation.
  
  
  RESULTS
  A significant reduction in tacrolimus blood levels requiring an increase in tacrolimus daily dose was observed postconversion. Postconversion tacrolimus blood level reduction >25% was significantly higher in the conversion group 1 mg:1 mg basis (P = .004). In patients converted 1 mg:1 mg, female sex and higher tacrolimus level at conversion were significant risk factors for a reduction >25% in tacrolimus blood levels after conversion. No significant change was detected between mean glomerular filtration rate at conversion (57 mL/min) and at 3, 6, and 9 months postconversion.
  
  
  CONCLUSIONS
  Once-daily tacrolimus at similar doses to the twice-daily formulation is an efficient and safe treatment option. Conversion made on 1 mg:1.1 mg basis seems advantageous at least in some patients.
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal; Nephrology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal. Electronic address: patricia820709barreto@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Barreto
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: J
authors.initials: J
authors.lastname: Malheiro
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal; Nephrology Department, Centro Hospitalar do Funchal, Funchal, Portugal.
authors.forename: P
authors.initials: P
authors.lastname: Vieira
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Pedroso
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: M
authors.initials: M
authors.lastname: Almeida
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: L S
authors.initials: LS
authors.lastname: Martins
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: L
authors.initials: L
authors.lastname: Dias
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: A C
authors.initials: AC
authors.lastname: Henriques
authors.affiliation: Nephrology Department, Centro Hospitalar do Porto, Porto, Portugal.
authors.forename: A
authors.initials: A
authors.lastname: Cabrita
mesh_terms: D000328:Adult; D003692:Delayed-Action Preparations / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000097:blood; D016030:Kidney Transplantation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage* / Q000097:blood; D066027:Transplant Recipients; D055815:Young Adult
chemical_list: D003692:Delayed-Action Preparations; D007166:Immunosuppressive Agents; D016559:Tacrolimus