Intrapatient variability of tacrolimus trough concentrations and its effect on serum creatinine level in kidney transplant recipients treated with nematvir/ritonavir

Zhang Yan; Hu Linkun; Miao Liyan

doi:10.3969/j.issn.1674-7445.2023.04.011

Volume 14 Issue 4

Jul. 2023

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Zhang Yan, Hu Linkun, Miao Liyan. Intrapatient variability of tacrolimus trough concentrations and its effect on serum creatinine level in kidney transplant recipients treated with nematvir/ritonavir[J]. ORGAN TRANSPLANTATION, 2023, 14(4): 547-552. doi: 10.3969/j.issn.1674-7445.2023.04.011

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Intrapatient variability of tacrolimus trough concentrations and its effect on serum creatinine level in kidney transplant recipients treated with nematvir/ritonavir

doi: 10.3969/j.issn.1674-7445.2023.04.011

Department of Pharmacy, the First Affiliated Hospital of Sochow University, Suzhou 215006, China

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Corresponding author: Miao Liyan, Email: miaolysuzhou@163.com
Received Date: 2023-03-03
Available Online: 2023-07-13
Publish Date: 2023-07-15

Abstract

Abstract

Objective To investigate the intra-patient variability (IPV) of tacrolimus trough concentrations and its effect on serum creatinine (Scr) level in kidney transplant recipients treated with nematvir/ritonavir. Methods Clinical data of 41 kidney transplant recipients infected by SARS-CoV-2 and treated with nematvir/ritonavir were collected. The usage of nematvir/ritonavir and tacrolimus was summarized. The distribution of tacrolimus trough concentrations and the attainment rate of target concentration were analyzed. The correlation between the IPV distribution of tacrolimus trough concentrations and the changes of Scr level was determined. Results Among 41 kidney transplant recipients, 46%(19/41) were given with full- and low-dose nematvir/ritonavir, and 7%(3/41) were given with high-dose nematvir/ritonavir. Use of tacrolimus was discontinued at 24 h before nematvir/ritonavir treatment in 95%(39/41) patients, and at 24 h after use of nematvir/ritonavir in 5%(2/41) patients. Tacrolimus was given at least 3 d after the 5-d course of nematvir/ritonavir in all patients. The attainment rate of tacrolimus trough concentration was 73%(30/41), 30%(3/10), 48%(15/31), 35%(11/31) and 53%(16/30) before, during, 1 week, 2 weeks and 1 month after use of nematvir/ritonavir, respectively. The median IPV was 35%(23%, 51%). Spearman correlation analysis showed that the increase of Scr level was positively correlated with IPV (r_s=0.400 7, P=0.028 2). Conclusions The attainment rate of tacrolimus trough concentration is declined in kidney transplant recipients treated with nematvir/ritonavir. The IPV of tacrolimus trough concentrations is elevated. The recipients with higher IPV are prone to an elevation in Scr level.
- Nematvir/ritonavir,
- SARS-CoV-2 infection,
- Kidney transplantation,
- Tacrolimus,
- Intra-patient variability,
- Serum creatinine,
- Estimated glomerular filtration rate,
- Drug interaction

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References

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Intrapatient variability of tacrolimus trough concentrations and its effect on serum creatinine level in kidney transplant recipients treated with nematvir/ritonavir

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Intrapatient variability of tacrolimus trough concentrations and its effect on serum creatinine level in kidney transplant recipients treated with nematvir/ritonavir

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