[Correlation of Blood Concentration of Tacrolimus with Serum Cystatin C in Renal Transplant Recipients and Effect of Tacrolimus on Glucose and Lipid Metabolism]

Overview

Journal Nan Fang Yi Ke Da Xue Xue Bao

Specialty General Medicine

Date 2017 Jul 4

PMID 28669959

Authors

Zhen-Bang Zhong

Li-Qian Mo

Yan Chen

Ping Zheng

Xi-Xiao Yang

Affiliations

Soon will be listed here.

Abstract

Objective: To investigate the correlation between blood concentrations of tacrolimus (FK506) and cystatin C (Cys C) and the effect of FK506 on glycolipid metabolism in renal transplant recipients.

Methods: A total of 325 patients receiving renal transplantation between August, 2014 and September, 2015 in Nanfang Hospital were divided into 4 groups according to the postoperative time (1 month group, 1-3 months group, 4-6 months group, and 7-12 months group). FK506 blood trough concentration was measured at the time of postoperative follow-up, and creatinine (Scr) and Cys C levels were also detected. Results Plasma FK506 concentration decreased with age in the recipients and showed a positive correlation with Cys C (r=0.985, P=0.015) but no obvious correlation with Scr (r=0.259, P=0.741). FK506 had no effect on blood glucose (5.53-5.59 mmol<L) or blood lipids (TG 1.47-1.55 mmol<L, TC 5.04-5.17 mmol<L, LDL-C 3.00-3.07 mmol<L, and VLDL 0.73-0.76 mmol<L) in patients 1-6 months after renal transplantation.

Conclusion: FK506 does not affect the level of glycolipid metabolism in patients after renal transplantation. Cys C is positively related to blood concentration of FK506 in the renal transplantation recipients. The rational use of FK506 can improve the effectiveness and safety of the treatment in the recipients.

References

Lopez-Giacoman S, Madero M . Biomarkers in chronic kidney disease, from kidney function to kidney damage. World J Nephrol. 2015; 4(1):57-73. PMC: 4317628. DOI: 10.5527/wjn.v4.i1.57. View

Ferraresso M, Turolo S, Belingheri M, Tirelli A, Cortinovis I, Milani S . Relationship between mRNA expression levels of CYP3A4, CYP3A5 and SXR in peripheral mononuclear blood cells and aging in young kidney transplant recipients under tacrolimus treatment. Pharmacogenomics. 2015; 16(5):483-91. DOI: 10.2217/pgs.15.18. View

Ruiz J, Herrero M, Boso V, Megias J, Hervas D, Poveda J . Impact of Single Nucleotide Polymorphisms (SNPs) on Immunosuppressive Therapy in Lung Transplantation. Int J Mol Sci. 2015; 16(9):20168-82. PMC: 4613195. DOI: 10.3390/ijms160920168. View

Pan P, Binjie H, Min L, Lipei F, Yanli N, Junwen Z . A meta-analysis on diagnostic value of serum cystatin C and creatinine for the evaluation of glomerular filtration function in renal transplant patients. Afr Health Sci. 2015; 14(4):1025-35. PMC: 4370085. DOI: 10.4314/ahs.v14i4.34. View

Kukla A, Issa N, Jackson S, Spong R, Foster M, Matas A . Cystatin C enhances glomerular filtration rate estimating equations in kidney transplant recipients. Am J Nephrol. 2014; 39(1):59-65. PMC: 4026030. DOI: 10.1159/000357594. View

Galindo R, Wallia A . Hyperglycemia and Diabetes Mellitus Following Organ Transplantation. Curr Diab Rep. 2016; 16(2):14. DOI: 10.1007/s11892-015-0707-1. View

Lancia P, Jacqz-Aigrain E, Zhao W . Choosing the right dose of tacrolimus. Arch Dis Child. 2014; 100(4):406-13. DOI: 10.1136/archdischild-2013-305888. View

Badiou S, Cristol J, Mourad G . Dyslipidemia following kidney transplantation: diagnosis and treatment. Curr Diab Rep. 2009; 9(4):305-11. DOI: 10.1007/s11892-009-0047-0. View

Levey A, Becker C, Inker L . Glomerular filtration rate and albuminuria for detection and staging of acute and chronic kidney disease in adults: a systematic review. JAMA. 2015; 313(8):837-46. PMC: 4410363. DOI: 10.1001/jama.2015.0602. View

10.

Chakkera H, Kudva Y, Kaplan B . Calcineurin Inhibitors: Pharmacologic Mechanisms Impacting Both Insulin Resistance and Insulin Secretion Leading to Glucose Dysregulation and Diabetes Mellitus. Clin Pharmacol Ther. 2016; 101(1):114-120. DOI: 10.1002/cpt.546. View

11.

McCormack P . Extended-release tacrolimus: a review of its use in de novo kidney transplantation. Drugs. 2014; 74(17):2053-64. DOI: 10.1007/s40265-014-0316-3. View

12.

Wallemacq P, Reding R . FK506 (tacrolimus), a novel immunosuppressant in organ transplantation: clinical, biomedical, and analytical aspects. Clin Chem. 1993; 39(11 Pt 1):2219-28. PMC: 2978067. View

13.

Calmus Y, Pageaux G . [Renal failure following liver transplantation]. Presse Med. 2009; 38(9):1314-8. DOI: 10.1016/j.lpm.2009.05.006. View

14.

Cheung C, Wong K, Chan H, Liu Y, Chan Y, Wong H . Paired kidney analysis of tacrolimus and cyclosporine microemulsion-based therapy in Chinese cadaveric renal transplant recipients. Transpl Int. 2006; 19(8):657-66. DOI: 10.1111/j.1432-2277.2006.00335.x. View

15.

Wanner C, Quaschning T . Abnormal lipid metabolism after renal transplantation. Ann Transplant. 2002; 6(1):5-8. View

16.

Dumont F . FK506, an immunosuppressant targeting calcineurin function. Curr Med Chem. 2000; 7(7):731-48. DOI: 10.2174/0929867003374723. View

17.

Shlipak M, Matsushita K, Arnlov J, Inker L, Katz R, Polkinghorne K . Cystatin C versus creatinine in determining risk based on kidney function. N Engl J Med. 2013; 369(10):932-43. PMC: 3993094. DOI: 10.1056/NEJMoa1214234. View

18.

Luo J, Wang L, Hu H, Zhang L, Li Y, Ai L . Cystatin C and cardiovascular or all-cause mortality risk in the general population: A meta-analysis. Clin Chim Acta. 2015; 450:39-45. DOI: 10.1016/j.cca.2015.07.016. View

19.

Senturk Ciftci H, Kilicaslan Ayna T, Caliskan Y, Turkmen A, Gurtekin M . Lipid parameters, doses and blood levels of calcineurin inhibitors in renal transplant patients. Indian J Clin Biochem. 2014; 28(2):164-8. PMC: 3613508. DOI: 10.1007/s12291-012-0251-6. View

20.

Ge J, Wang J, Zhao H, Li K, Jing Y, Li G . Impact of FOXP3 Polymorphisms on the Blood Level of Tacrolimus in Renal Transplant Recipients. Transplant Proc. 2016; 48(6):1962-7. DOI: 10.1016/j.transproceed.2016.04.016. View