Back to Search
Start Over
Lower calcineurin inhibitor doses in older compared to younger kidney transplant recipients yield similar troughs.
- Source :
-
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2012 Dec; Vol. 12 (12), pp. 3326-36. Date of Electronic Publication: 2012 Sep 04. - Publication Year :
- 2012
-
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.<br /> (© Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Calcineurin metabolism
Cyclosporine administration & dosage
Cyclosporine pharmacokinetics
Cytochrome P-450 CYP3A genetics
Female
Genetic Variation genetics
Humans
Immunosuppressive Agents pharmacokinetics
Male
Middle Aged
Prognosis
Prospective Studies
Tacrolimus administration & dosage
Tacrolimus pharmacokinetics
Tissue Distribution
Young Adult
Calcineurin Inhibitors
Immunosuppressive Agents administration & dosage
Kidney Transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 1600-6143
- Volume :
- 12
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 22947444
- Full Text :
- https://doi.org/10.1111/j.1600-6143.2012.04232.x