Observational studyClinical pharmacokinetics2026
Impacts of Uremic Toxins on the Population Pharmacokinetics of Total Mycophenolic Acid and its Glucuronide Metabolite in Adult Kidney Transplant Recipients.
Observational study in Clinical pharmacokinetics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
BACKGROUND AND
objectiveMycophenolic acid (MPA) exhibits considerable inter-individual variability in drug exposure, which can result in acute graft rejection as well as hematological or infectious adverse effects. Evidence from our group and others indicates that certain uremic toxins may contribute to this variability through pharmacokinetic (PK) interactions. This study aimed to develop a novel population PK (popPK) model to investigate how conjugated metabolites of p-cresol and indole (i.e., toxicokinetically important uremic toxins) affect total MPA PK, and to conduct model-based simulations to identify potentially relevant dosing recommendations.
methodsA prospective observational study enrolled adult kidney transplant recipients on steady-state oral mycophenolate mofetil (MMF; prodrug of MPA) with tacrolimus (±prednisone). Total plasma concentrations of p-cresol sulfate (pCS), p-cresol glucuronide (pCG), indoxyl sulfate (IxS), indoxyl glucuronide (IxG), MPA, and its major glucuronide metabolite (MPAG) were quantified with our validated liquid chromatography tandem-mass spectrometry assays. PopPK modelling was conducted with stochastic approximation expectation-maximization, and Monte-Carlo simulation was used to assess the potential impacts of significant covariates on MPA exposure.
resultsForty-one participants contributed 283 samples across three early post-transplant periods (~1, ~3, and ~6 months). The final popPK model was described by first-order absorption (K
conclusionTo our knowledge, this is the first popPK model to mechanistically characterize PK interactions between uremic toxins and total MPA in kidney transplant recipients. Our findings indicate that each toxin has distinct interaction effects, with pCS emerging as potentially relevant. Additional investigations are required to elucidate the clinical impacts of the identified toxin-MPA PK interactions in this population.
Indexed as
Identifiers
42065853What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.