Overview of tacrolimus levels in kidney transplant patients at a hospital in Ceará

Abstract

Objective: To correlate medication and associated factors with changes in tacrolimus levels in post-transplant patients at a University Hospital in Ceará. Methods: This was a retrospective observational study using data from medical records (n=181) (March/2019-May/2022). Sociodemographic variables, comorbidities, tacrolimus levels in the blood (on the date, 30 days, and 1 year after discharge), and the pharmacotherapy used at discharge were evaluated. Results: There was a predominance of male patients aged between 31 and 59 who were unable to read or write at the first-grade level. In addition, hypertensive, diabetic, and dyslipidemic patients predominated. The average hospital stay was 21.52 ± 16.11 days, with 64.1% of patients using 5-10 drugs. Interactions of the immunosuppressants used with amlodipine, isoniazid, omeprazole, and prednisone were detected. Thirty days and one year after discharge, changes in tacrolimus levels were reduced (p = 0.0029). There was a correlation between age and tacrolimus levels at discharge (Rho = 0.169; p = 0.023) and a linear regression model in which diabetes mellitus predicts an increase of 1.195 ng/mL (95%CI=0.436-1.955) in tacrolimus concentration at discharge [X²(1; n=181) = 9.655; R² = 0.051; p = 0.002]. Conclusion: It can be concluded that age and diabetes mellitus are factors that can interfere with tacrolimus concentration, and there is a greater need to monitor post-transplant patients.