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Guirado L, Burgos D, Cantarell C, et al. Medium-Term Renal Function in a Large Cohort of Stable Kidney Transplant Recipients Converted From Twice-Daily to Once-Daily Tacrolimus. Transplant Direct. 2015;1(7):e24doi: 10.1097/TXD.0000000000000536.
Guirado, L., Burgos, D., Cantarell, C., Fernández, A., Franco, A., Gentil, M. �. �., Mazuecos, A., Torregrosa, J. V., Huertas, E. G., Ruiz, J. C., Plumed, J. S., Paul, J., Lauzurica, R., Zárraga, S., Osuna, A., Jiménez, C., Alonso, �. �., Rodríguez, A., Bardají, B., & Hernández, D. (2015). Medium-Term Renal Function in a Large Cohort of Stable Kidney Transplant Recipients Converted From Twice-Daily to Once-Daily Tacrolimus. Transplantation direct, 1(7), e24. https://doi.org/10.1097/TXD.0000000000000536
Guirado, Lluís, et al. "Medium-Term Renal Function in a Large Cohort of Stable Kidney Transplant Recipients Converted From Twice-Daily to Once-Daily Tacrolimus." Transplantation direct vol. 1,7 (2015): e24. doi: https://doi.org/10.1097/TXD.0000000000000536
Guirado L, Burgos D, Cantarell C, Fernández A, Franco A, Gentil MÁ, Mazuecos A, Torregrosa JV, Huertas EG, Ruiz JC, Plumed JS, Paul J, Lauzurica R, Zárraga S, Osuna A, Jiménez C, Alonso Á, Rodríguez A, Bardají B, Hernández D. Medium-Term Renal Function in a Large Cohort of Stable Kidney Transplant Recipients Converted From Twice-Daily to Once-Daily Tacrolimus. Transplant Direct. 2015 Aug 05;1(7):e24. doi: 10.1097/TXD.0000000000000536. eCollection 2015 Aug. PMID: 27500226; PMCID: PMC4946473.
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Transplant Direct. 2015 Aug 05;1(7):e24. doi: 10.1097/TXD.0000000000000536. eCollection 2015 Aug.

Medium-Term Renal Function in a Large Cohort of Stable Kidney Transplant Recipients Converted From Twice-Daily to Once-Daily Tacrolimus.

Transplantation direct

Lluís Guirado, Dolores Burgos, Carme Cantarell, Ana Fernández, Antonio Franco, Miguel Ángel Gentil, Auxiliadora Mazuecos, Josep Vicenç Torregrosa, Ernesto Gómez Huertas, Juan Carlos Ruiz, Jaime Sánchez Plumed, Javier Paul, Ricardo Lauzurica, Sofía Zárraga, Antonio Osuna, Carlos Jiménez, Ángel Alonso, Alberto Rodríguez, Beatriz Bardají, Domingo Hernández

Affiliations

  1. Renal Transplant Unit, Fundació Puigvert, Barcelona, Spain.
  2. Nephrology Department, Hospital Regional Universitario Carlos Haya, Málaga, Spain.
  3. Nephrology Department, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.
  4. Nephrology Department, Hospital Ramón y Cajal, Madrid, Spain.
  5. Nephrology Department, Hospital General de Alicante, Alicante, Spain.
  6. Clinical Nephrology and Urology Unit, Hospital Virgen del Rocío, Sevilla, Spain.
  7. Nephrology Department, Hospital Puerta del Mar, Cádiz, Spain.
  8. Renal Transplant Unit, Hospital Clínic Barcelona, Spain.
  9. Nephrology Department, Hospital Universitario Central de Asturias, Oviedo, Spain.
  10. Nephrology Department, Hospital Marqués de Valdecilla, Santander, Spain.
  11. Nephrology Department, Hospital La Fe, Valencia, Spain.
  12. Nephrology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain.
  13. Nephrology Department, Hospital Germans Trias i Pujol, Barcelona, Spain.
  14. Nephrology Department, Hospital de Cruces, Bilbao, Spain.
  15. Nephrology Department, Hospital Virgen de las Nieves, Granada, Spain.
  16. Nephrology Department, Hospital La Paz, Madrid, Spain.
  17. Nephrology Department, Complejo Hospitalario A Coruña, A Coruña, Spain.
  18. Nephrology Department, Hospital Reina Sofia, Córdoba, Spain.
  19. Statistics Department, Fundació Puigvert, Barcelona, Spain.

PMID: 27500226 PMCID: PMC4946473 DOI: 10.1097/TXD.0000000000000536

Abstract

BACKGROUND: There is some evidence pointing toward better renal function in kidney transplant recipients (KTR) treated with once-daily tacrolimus (QD-TAC) vs. twice-daily tacrolimus (BID-TAC).

METHODS: This is an extension study of a 1-year, single arm prospective study of stable KTR who were converted from BID-TAC to QD-TAC (4.9 ± 4.0 years after transplantation) in Spanish routine clinical practice. Patient and graft survival, renal function, acute rejection episodes, and other analytic parameters were assessed at 24 and 36 months after conversion.

RESULTS: A total of 1798 KTR were included in the extension study. Tacrolimus doses at 36 months were significantly lower compared to those at time of conversion (-0.2 mg/day; P = 0.023). Blood levels were lower than baseline during all the study (P < 0.001). Graft and patient survival at 3 years after conversion were 93.9% and 95.1%, respectively. Compared with baseline, the mean estimated glomerular filtration rate (eGFR) remained very stable at all timepoints (56.7 ± 19.8 vs 58.1 ± 24.6 mL/min per 1.73 m(2) at month 36; P = 0.623). Even when patients reinitiating dialysis were counted as eGFR = 0, the mean eGFR was very stable. In fact, a small but significant increase was observed at 36 months versus baseline (+0.1 mL/min per 1.73 m(2); P = 0.025). An increase in proteinuria was observed at 36 months versus baseline (+0.11 g/24 h; P < 0.001). Acute rejection rates were low during the study.

CONCLUSIONS: Conversion from BID-TAC to QD-TAC in a large cohort of stable KTR was safe and associated with a very stable renal function after 3 years. Comparative studies are warranted to assess the feasibility of such conversion.

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