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Influence of tacrolimus metabolism rate on BKV infection after kidney transplantation

Immunosuppression is the major risk factor for BK virus nephropathy (BKVN) after renal transplantation (RTx). As the individual tacrolimus (Tac) metabolism rate correlates with Tac side effects, we hypothesized that Tac metabolism might also influence the BKV infection risk. In this case-control study RTx patients with BK viremia within 4 years after RTx (BKV group) were compared with a BKV negative control group. The Tac metabolism rate expressed as the blood concentration normalized by the daily dose (C/D ratio) was applied to assess the Tac metabolism rate. BK viremia was detected in 86 patients after a median time of 6 (0–36) months after RTx. BKV positive patients showed lower Tac C/D ratios at 1, 3 and 6 months after RTx and were classified as fast Tac metabolizers. 8 of 86 patients with BK viremia had histologically proven BKN and a higher median maximum viral load than BKV patients without BKN (441,000 vs. 18,572 copies/mL). We conclude from our data that fast Tac metabolism (C/D ratio <1.05) is associated with BK viremia after RTx. Calculation of the Tac C/D ratio early after RTx, may assist transplant clinicians to identify patients at risk and to choose the optimal immunosuppressive regimen.

Titel: Influence of tacrolimus metabolism rate on BKV infection after kidney transplantation
Verfasser: Thölking, Gerold Bernhard GND
Schmidt, Christina
Koch, Raphael GND
Schütte-Nütgen, Katharina GND
Pabst, Dirk GND
Wolters, Heiner GND
Kabar, Iyad GND
Hüsing, Anna Katharina Elisabeth Pia GND
Pavenstädt, Hermann GND
Reuter, Stefan
Suwelack, Barbara
Urheber: Universitäts- und Landesbibliothek Münster GND
Organisation: FB 05: Medizinische Fakultät
Dokumenttyp: Artikel
Medientyp: Text
Erscheinungsdatum: 30.08.2016
Publikation in MIAMI: 08.05.2017
Datum der letzten Änderung: 08.05.2017
Quelle: Scientific Reports 6 (2016) 32273, 1-8
Fachgebiete: Medizin und Gesundheit
Lizenz: CC BY 4.0
Sprache: Englisch
Anmerkungen: Finanziert durch den Open-Access-Publikationsfonds 2015/2016 der Westfälischen Wilhelms-Universität Münster (WWU Münster).
Format: PDF-Dokument
URN: urn:nbn:de:hbz:6-82239633479
Permalink: https://nbn-resolving.org/urn:nbn:de:hbz:6-82239633479
DOI: 10.1038/srep32273
ISSN: 2045-2322
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