Immediate-Release versus Extended-Release Tacrolimus: Comparing Blood Pressure Control in Kidney Transplant Recipients - A Retrospective Cohort Study.

IF 2.3 4区医学 Q2 UROLOGY & NEPHROLOGY Nephron Pub Date : 2024-09-22 DOI:10.1159/000541334

Chien-Wen Yang, Juan Carlos Q Velez, Debbie L Cohen

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Abstract

Background: Hypertension (HTN) is a common side effect of tacrolimus (Tac), the first-line antirejection medication for kidney transplant recipients. The impact of immediate-release tacrolimus (Tac IR) dosed twice daily versus extended-release tacrolimus (Tac ER) dosed once daily on long-term blood pressure control in kidney transplant recipients remains understudied. This study aims to compare the use of Tac IR versus Tac ER in kidney transplant recipients and evaluate the effects of the different formulations on systolic blood pressure (SBP), diastolic blood pressure (DBP), and HTN crisis.

Methods: This retrospective cohort study at a single institution collected baseline characteristics, time-varying exposure to Tac IR versus Tac ER, SBP, DBP, HTN crisis, and confounders at each posttransplant visit. A marginal structural linear mixed-effects model was employed to analyze the longitudinal blood pressure control in kidney transplant recipients receiving Tac IR and Tac ER.

Results: The final analysis included 654 patients, with mean ages of 52.0 years for Tac IR and 50.3 years for Tac ER. Males constituted 56.7% in Tac IR and 55.0% in Tac ER. Notably, the black population had 2.44 times higher odds of receiving Tac ER after adjusting for the rest of the baseline characteristics. No difference was found between longitudinal SBP (p = 0.386, 95% CI: -1.00, 2.57) or DBP (p = 0.797, 95% CI: -1.38, 1.06).

Conclusion: Our study indicates that posttransplant patients taking Tac ER exhibit no difference in chronic SBP and DBP controls compared to Tac IR.

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速释与缓释他克莫司：比较肾移植受者的血压控制 - 一项回顾性队列研究。

背景高血压（HTN）是肾移植受者一线抗排斥药物他克莫司（Tac）的常见副作用。在肾移植受者中，每天服用两次的速释他克莫司（Tac IR）与每天服用一次的缓释他克莫司（Tac ER）对长期血压控制的影响仍未得到充分研究。本研究旨在比较肾移植受者使用 Tac IR 和 Tac ER 的情况，并评估不同制剂对收缩压 (SBP)、舒张压 (DBP) 和高血压危机的影响。方法该回顾性队列研究在一家机构进行，收集了移植后每次就诊时的基线特征、Tac IR 与 Tac ER 的时变暴露、SBP、DBP、HTN 危机和混杂因素。采用边际结构线性混合效应模型分析了接受 Tac IR 和 Tac ER 治疗的肾移植受者的纵向血压控制情况。结果最终分析包括 654 名患者，Tac IR 患者的平均年龄为 52.0 岁，Tac ER 患者的平均年龄为 50.3 岁。男性在 Tac IR 中占 56.7%，在 Tac ER 中占 55.0%。值得注意的是，在调整了其他基线特征后，黑人接受 Tac ER 的几率要高出 2.44 倍。纵向 SBP（p=0.386，95% CI：-1.00，2.57）或 DBP（p=0.797，95% CI：-1.38，1.06）之间未发现差异。结论我们的研究表明，与 Tac IR 相比，服用 Tac ER 的移植后患者在慢性 SBP 和 DBP 控制方面没有差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nephron UROLOGY & NEPHROLOGY-

CiteScore

5.00

自引率

0.00%

发文量

期刊介绍： ''Nephron'' comprises three sections, which are each under the editorship of internationally recognized leaders and served by specialized Associate Editors. Apart from high-quality original research, ''Nephron'' publishes invited reviews/minireviews on up-to-date topics. Papers undergo an innovative and transparent peer review process encompassing a Presentation Report which assesses and summarizes the presentation of the paper in an unbiased and standardized way.