Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring

Mycophenolate mofetil is a key immunosuppressant that is metabolized into mycophenolic acid (MPA). The prognostic impact of MPA-focused therapeutic drug monitoring on allograft prognosis has not been determined in kidney transplant recipients with diabetes. In this study, we assessed the pharmacokin...

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Autores principales:	Eisuke Nakamura, Tadashi Sofue, Yasushi Kunisho, Keisuke Onishi, Kazunori Yamaguchi, Emi Ibuki, Rikiya Taoka, Nobufumi Ueda, Mikio Sugimoto, Tetsuo Minamino
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	kidney transplantation diabetes mycophenolic acid therapeutic drug monitoring Medicine R
Acceso en línea:	https://doaj.org/article/2f26fafbdba94ba98ff9e07d32467697
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spelling	oai:doaj.org-article:2f26fafbdba94ba98ff9e07d324676972021-11-25T18:08:10ZTransplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring10.3390/jpm111112242075-4426https://doaj.org/article/2f26fafbdba94ba98ff9e07d324676972021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4426/11/11/1224https://doaj.org/toc/2075-4426Mycophenolate mofetil is a key immunosuppressant that is metabolized into mycophenolic acid (MPA). The prognostic impact of MPA-focused therapeutic drug monitoring on allograft prognosis has not been determined in kidney transplant recipients with diabetes. In this study, we assessed the pharmacokinetics of MPA and allograft prognosis in recipients with diabetes. This study retrospectively analyzed 64 adult kidney transplant recipients. MPA blood concentration data (e.g., the time to the maximum concentration (Tmax), and the area under the concentration–time curve from 0 to 12 h (AUC<sub>0–12</sub>)) were collected at 3 weeks and 3 months after kidney transplantation. Of the 64 recipients, 15 had pre-existing diabetes. At 3 months after kidney transplantation, the Tmax of MPA was significantly longer in recipients with diabetes (mean (standard deviation): 2.8 (2.1) h) than in recipients without diabetes (1.9 (1.1) h, <i>p</i> = 0.02). However, the allograft estimated glomerular filtration rate and acute rejection rate, including borderline change, did not differ according to the diabetes status in patients with adjusted AUC<sub>0–12</sub> of MPA within the target range. In conclusion, a longer Tmax of MPA was observed in recipients with diabetes; however, acceptable allograft prognosis was observed in kidney transplant recipients with diabetes and a sufficient AUC<sub>0–12</sub> of MPA.Eisuke NakamuraTadashi SofueYasushi KunishoKeisuke OnishiKazunori YamaguchiEmi IbukiRikiya TaokaNobufumi UedaMikio SugimotoTetsuo MinaminoMDPI AGarticlekidney transplantationdiabetesmycophenolic acidtherapeutic drug monitoringMedicineRENJournal of Personalized Medicine, Vol 11, Iss 1224, p 1224 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	kidney transplantation diabetes mycophenolic acid therapeutic drug monitoring Medicine R
spellingShingle	kidney transplantation diabetes mycophenolic acid therapeutic drug monitoring Medicine R Eisuke Nakamura Tadashi Sofue Yasushi Kunisho Keisuke Onishi Kazunori Yamaguchi Emi Ibuki Rikiya Taoka Nobufumi Ueda Mikio Sugimoto Tetsuo Minamino Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring
description	Mycophenolate mofetil is a key immunosuppressant that is metabolized into mycophenolic acid (MPA). The prognostic impact of MPA-focused therapeutic drug monitoring on allograft prognosis has not been determined in kidney transplant recipients with diabetes. In this study, we assessed the pharmacokinetics of MPA and allograft prognosis in recipients with diabetes. This study retrospectively analyzed 64 adult kidney transplant recipients. MPA blood concentration data (e.g., the time to the maximum concentration (Tmax), and the area under the concentration–time curve from 0 to 12 h (AUC<sub>0–12</sub>)) were collected at 3 weeks and 3 months after kidney transplantation. Of the 64 recipients, 15 had pre-existing diabetes. At 3 months after kidney transplantation, the Tmax of MPA was significantly longer in recipients with diabetes (mean (standard deviation): 2.8 (2.1) h) than in recipients without diabetes (1.9 (1.1) h, <i>p</i> = 0.02). However, the allograft estimated glomerular filtration rate and acute rejection rate, including borderline change, did not differ according to the diabetes status in patients with adjusted AUC<sub>0–12</sub> of MPA within the target range. In conclusion, a longer Tmax of MPA was observed in recipients with diabetes; however, acceptable allograft prognosis was observed in kidney transplant recipients with diabetes and a sufficient AUC<sub>0–12</sub> of MPA.
format	article
author	Eisuke Nakamura Tadashi Sofue Yasushi Kunisho Keisuke Onishi Kazunori Yamaguchi Emi Ibuki Rikiya Taoka Nobufumi Ueda Mikio Sugimoto Tetsuo Minamino
author_facet	Eisuke Nakamura Tadashi Sofue Yasushi Kunisho Keisuke Onishi Kazunori Yamaguchi Emi Ibuki Rikiya Taoka Nobufumi Ueda Mikio Sugimoto Tetsuo Minamino
author_sort	Eisuke Nakamura
title	Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring
title_short	Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring
title_full	Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring
title_fullStr	Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring
title_full_unstemmed	Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring
title_sort	transplant prognosis in kidney transplant recipients with diabetes under mycophenolic acid-focused therapeutic drug monitoring
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2f26fafbdba94ba98ff9e07d32467697
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Transplant Prognosis in Kidney Transplant Recipients with Diabetes under Mycophenolic Acid-Focused Therapeutic Drug Monitoring

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