<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Background</bold>: Therapeutic drug monitoring (TDM) in patients with Chronic Kidney Disease (CKD) with kidney transplant, represents a major post transplant concern due to the characteristics of this special category of patients, particularities which can generate changes of the pharmacokinetic profile of the administered medication.<bold>Material and methods</bold>: The current study is a retrospective pharmacokinetic study, over a period of 50 months, including a group of 36 kidney transplanted patients with CKD. Tacrolimus blood concentration was determined by a validated high-performance liquid chromatography method (HPLC), at a 12 hour time interval from the last administration of the immunosuppressive medication and before the following dose (Residual concentration, Cmin(trough)).<bold>Results</bold>: During the monitoring of therapy, based on the pharmacokinetic criteria, 252 measurements of blood concentration were determined, 58 of these being outside the therapeutic window.<bold>Conclusions</bold>: The results obtained show that it is mandatory to continue to monitor closely medical therapy based on the pharmacokinetic criteria in view of improving drug administration. The other ways of monitoring therapy: the clinical and biochemical criteria should not be overlooked. In addition, the interindividual variability of patients should be considered, as well as drug interaction which can alter the pharmacokinetics of tacrolimus.</abstract>

Background: Therapeutic drug monitoring (TDM) in patients with Chronic Kidney Disease (CKD) with kidney transplant, represents a major post transplant concern due to the characteristics of this special category of patients, particularities which can generate changes of the pharmacokinetic profile of the administered medication.Material and methods: The current study is a retrospective pharmacokinetic study, over a period of 50 months, including a group of 36 kidney transplanted patients with CKD. Tacrolimus blood concentration was determined by a validated high-performance liquid chromatography method (HPLC), at a 12 hour time interval from the last administration of the immunosuppressive medication and before the following dose (Residual concentration, Cmin(trough)).Results: During the monitoring of therapy, based on the pharmacokinetic criteria, 252 measurements of blood concentration were determined, 58 of these being outside the therapeutic window.Conclusions: The results obtained show that it is mandatory to continue to monitor closely medical therapy based on the pharmacokinetic criteria in view of improving drug administration. The other ways of monitoring therapy: the clinical and biochemical criteria should not be overlooked. In addition, the interindividual variability of patients should be considered, as well as drug interaction which can alter the pharmacokinetics of tacrolimus.

The Monitoring of Immunosuppressive Therapy with Tacrolimus in Patients with Kidney Transplant, Based on the Pharmacokinetic Criteria

Department of Nephrology, University of Medicine and Pharmacy, Târgu-Mureş, România

Department of Physiology, University of Medicine and Pharmacy, Târgu-Mureş, România

Department of Pharmacology and Clinical Pharmacy, University of Medicine and Pharmacy, Târgu-Mureş, România

Department of Internal Medicine IV, University of Medicine and Pharmacy, Târgu-Mureş, România

Acta Marisiensis - Seria Medica

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Background: Therapeutic drug monitoring (TDM) in patients with Chronic Kidney Disease (CKD) with kidney transplant, represents a major post transplant concern...

The Monitoring of Immunosuppressive Therapy with Tacrolimus in Patients with Kidney Transplant, Based on the Pharmacokinetic Criteria

Published Online: Jan 19, 2016

Page range: 265 - 268

Received: Jun 21, 2015

Accepted: Aug 03, 2015

DOI: https://doi.org/10.1515/amma-2015-0082

Keywords
chronic kidney disease, therapeutic drug monitoring, high performance liquid chromatography, pharmacokinetics

© 2015 Stoica Ciprian Mihai et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

The Monitoring of Immunosuppressive Therapy with Tacrolimus in Patients with Kidney Transplant, Based on the Pharmacokinetic Criteria

Published Online: Jan 19, 2016

Page range: 265 - 268

Received: Jun 21, 2015

Accepted: Aug 03, 2015

DOI: https://doi.org/10.1515/amma-2015-0082

Keywordschronic kidney disease, therapeutic drug monitoring, high performance liquid chromatography, pharmacokinetics

© 2015 Stoica Ciprian Mihai et al., published by De Gruyter Open

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Keywords
chronic kidney disease, therapeutic drug monitoring, high performance liquid chromatography, pharmacokinetics