ArticleScientific reports2021
Increased renal function decline in fast metabolizers using extended-release tacrolimus after kidney transplantation.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 17 citations in OpenAlex.
- Tacrolimus Concentration/Dose Ratio in Hematopoietic Cell Transplantation Recipients: An Exploratory Study of Metabolizer Phenotyping and Clinical Outcomes.Clinical and translational science · 2026Article
- Continuity of care and risk of vision loss in patients with newly developed macular degeneration.Acta ophthalmologica · 2026Article
- Impact of dose-adjusted tacrolimus exposure phenotype on outcomes in kidney transplantation: a large-scale multicenter cohort study.Frontiers in immunology · 2026Article
- Impact of tacrolimus peak concentration on kidney graft outcomes.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- New-Onset Diabetes After Transplantation in Renal Recipients: A Pilot Comparative Study of Immediate vs. Extended-Release Tacrolimus Formulation.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Early Determination of Tacrolimus Concentration-Dose Ratio Identifies Risk of Allograft Loss in Kidney Transplantation.Kidney international reports · 2025Article
- Renal Allograft Function and the Tacrolimus C/D Ratio: Insights from a Prospective Study on MeltDose Tacrolimus.Journal of clinical medicine · 2024Article
- The use of extended-release tacrolimus twice a day might be beneficial for selected kidney transplant recipients: a case report.Frontiers in medicine · 2024Article
- Tacrolimus-why pharmacokinetics matter in the clinic.Frontiers in transplantation · 2023Review
- The Tacrolimus Concentration/Dose Ratio Does Not Predict Early Complications After Kidney Transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Fast Tacrolimus Metabolism Does Not Promote Post-Transplant Diabetes Mellitus after Kidney Transplantation.International journal of molecular sciences · 2022Article
- Impact of continuity of care on risk for major osteoporotic fracture in patients with new onset rheumatoid arthritis.Scientific reports · 2022Article
- Improved Kidney Allograft Function after Early Conversion of Fast IR-Tac Metabolizers to LCP-Tac.Journal of clinical medicine · 2022Article
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Fast metabolism of immediate-release tacrolimus (IR-Tac) is associated with decreased kidney function after renal transplantation (RTx) compared to slow metabolizers. We hypothesized, by analogy, that fast metabolism of extended-release tacrolimus (ER-Tac) is associated with worse renal function. We analyzed data from patients who underwent RTx at three different transplant centers between 2007 and 2016 and received an initial immunosuppressive regimen with ER-Tac, mycophenolate, and a corticosteroid. Three months after RTx, a Tac concentration to dose ratio (C/D ratio) < 1.0 ng/ml · 1/mL defined fast ER-Tac metabolism and ≥ 1.0 ng/ml · 1/mL slow metabolism. Renal function (estimated glomerular filtration rate, eGFR), first acute rejection (AR), conversion from ER-Tac, graft and patient survival were observed up to 60-months. 610 RTx patients were divided into 192 fast and 418 slow ER-Tac metabolizers. Fast metabolizers showed a decreased eGFR at all time points compared to slow metabolizers. The fast metabolizer group included more patients who were switched from ER-Tac (p < 0.001). First AR occurred more frequently (p = 0.008) in fast metabolizers, while graft and patient survival rates did not differ between groups (p = 0.529 and p = 0.366, respectively). Calculation of the ER-Tac C/D ratio early after RTx may facilitate individualization of immunosuppression and help identify patients at risk for an unfavorable outcome.
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