ArticleAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons2012
Lower calcineurin inhibitor doses in older compared to younger kidney transplant recipients yield similar troughs.
Article in American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers.
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Who cites it
52 citing papers in PubMed, 101 citations in OpenAlex.
- Infections after kidney transplantation. Does age matter?Clinical transplantation · 2019Trial
- Multidrug resistance-associated protein 2 (MRP2/ABCC2) haplotypes significantly affect the pharmacokinetics of tacrolimus in kidney transplant recipients.Clinical pharmacokinetics · 2013Trial
- Impact of aging on the pharmacokinetic profile of everolimus in male mice.BMC pharmacology & toxicology · 2026Article
- Age-specific impact of different immunosuppressive regimens on kidney transplant outcomes: clinical evidence from the scientific registry of transplant recipients.Frontiers in nephrology · 2026Article
- A Population Pharmacokinetic Model and Dosing Algorithm to Guide the Tacrolimus Starting and Follow-Up Dose in Living and Deceased Donor Kidney Transplant Recipients.Clinical pharmacokinetics · 2025Article
- Does Age Influence Immunosuppressant Drug Pharmacokinetics in Kidney Transplant Recipients?European journal of drug metabolism and pharmacokinetics · 2024Article
- Management of Scleritis in Older Adults.Drugs & aging · 2024Article
- Impact of Immunosenescence in Older Kidney Transplant Recipients: Associated Clinical Outcomes and Possible Risk Stratification for Immunosuppression Reduction.Drugs & aging · 2024Review
- Immune aging: biological mechanisms, clinical symptoms, and management in lung transplant recipients.Frontiers in transplantation · 2024Review
- Article
- Tamoxifen pharmacokinetics and pharmacodynamics in older patients with non-metastatic breast cancer.Breast cancer research and treatment · 2023Article
- The aging of the immune system and its implications for transplantation.GeroScience · 2023Review
- Age associations with tacrolimus and mycophenolic acid pharmacokinetics in stable Black and White kidney transplant recipients: Implications for health inequities.Clinical and translational science · 2023Article
- Tacrolimus-why pharmacokinetics matter in the clinic.Frontiers in transplantation · 2023Review
- Sensitivity of estimated tacrolimus population pharmacokinetic profile to assumed dose timing and absorption in real-world data and simulated data.British journal of clinical pharmacology · 2022Article
- Heart Transplant in Older Adults.Current transplantation reports · 2022Review
- Precision Dosing for Tacrolimus Using Genotypes and Clinical Factors in Kidney Transplant Recipients of European Ancestry.Journal of clinical pharmacology · 2021Observational
- Immunosuppression Regimen Use and Outcomes in Older and Younger Adult Kidney Transplant Recipients: A National Registry Analysis.Transplantation · 2021Article
- Immunosuppression Considerations for Older Kidney Transplant Recipients.Current transplantation reports · 2021Article
- Clinical Experience with Extended-Release Tacrolimus in Older Adult Kidney Transplant Recipients: A Retrospective Cohort Study.Drugs & aging · 2021Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
The number of older adults undergoing kidney transplantation has increased, yet little is known about calcineurin inhibitor (CNI) metabolism in this group. We studied CNI troughs and doses to determine if there were age-related differences in metabolism and dose requirements. We studied 348 young (18-34 years), 1831 middle (35-64 years) and 374 older (65-84 years) adult kidney transplant recipients enrolled in a seven-center prospective study. Troughs were obtained from each patient 2×/week in weeks 1-8 and 2×/month in months 3-6. A multivariable linear-mixed model examined the effect of age on log dose and weight normalized troughs. Older recipients had higher normalized tacrolimus troughs than middle or young age adults despite receiving doses a median of 1-2 mg/day lower. Age and CYP3A5*1 genotype had the largest effect on tacrolimus troughs. Older recipients also had higher normalized cyclosporine troughs than middle or young adults despite receiving median doses 100 mg/day lower. After normalization for dose and weight, CNI troughs were more than 50% higher in older adults than young adults. These data support age-related changes in CNI metabolism. Further studies are needed to determine optimal dosing of CNIs in the elderly.
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