MỘT SỐ YẾU TỐ ẢNH HƯỞNG ĐẾN SỰ BIẾN THIÊN NỒNG ĐỘ TACROLIMUS TRÊN NGƯỜI BỆNH GHÉP THẬN TẠI BỆNH VIỆN HỮU NGHỊ VIỆT ĐỨC

Abstract

Objectives: To analyze usage characteristics and Tacrolimus (TAC) trough level variability over time, and to analyze some factors affecting the intra-patient variability in TAC exposure in the first year after kidney transplantation. Methods: A retrospective, descriptive study was conducted based on medical records of patients who underwent kidney transplantation and had regular follow-up at the Department of Kidney Diseases and Dialysis, Viet Duc University Hospital, from January 1, 2019 to June 30, 2023. Results: 274 medical records of 274 kidney transplant patients were included. Dosage, trough concentrations, and intra-individual variability (IPV) of TAC trough concentrations tended to decrease over time. Logistic regression analysis revealed factors associated with high IPV (CV > 30%) in the first month after transplantation including concomitant use of azole antifungal agents non-continuously vs. continuously use vs. no use (OR = 16.51; p < 0.001); concomitant use of diltiazem non-continuously vs continuously use or no use (OR = 2.92; p = 0.002); factors during the 2 - 6 month period included hematocrit (OR = 0.86; p = 0.001) and mean C₀/D ratio (OR = 1.41; p < 0.001); during the 6 - 12-month period, switching between twice-daily and once-daily formulations compared to no switching was associated (OR = 1.17; p = 0.004). Conclusion: TAC trough levels IPV decrease over time after transplantation. High IPV of TAC levels includes concomitant use of azole antifungal and diltiazem agents non-continuously; hematocrit and switching between twice-daily and once-daily formulations.