Background/Aim. A combination of tacrolimus and other drugs such as
corticosteroids has been commonly used immunosuppresive regimens. On the
other hand, there is a growing body of evidence that male and female may
differ in their response to the equal drug treatment. The aim of the study
was to estimated the use of tacrolimus concentration/dose (C/D) ratio for the
assessment of the influence of gender differences and comedication on
tacrolimus exposure in renal transplant recipients. Methods. This prospective
case series study included 54 patients, in which the unit of monitoring was
outpatient examination (1,872) of the renal transplant patients. The patients
were monitored in the period 2010-2014, starting one month after the
transplantation. Tacrolimus trough concentrations (TTC) were measured by
chemiluminescence microparticles immunoassay. Results. TTC and the
tacrolimus C/D ratio were significantly lower in the females comparing with
the males. Contrary to the males, in the females a significant increase of
the tacrolimus daily dose (TDD) per body weight and TTC, along with the
corticosteroid dose increase, was not accompanied by any significant changes
in the tacrolimus C/D ratio; in different corticosteroid doses faster
elimination of tacrolimus was found with the exception of the doses > 0.25
mg/kg. In the patients treated with proton pump inhibitors, mainly with
pantoprazole TDD per body weight and TTC were significantly higher, while the
tacrolimus C/D ratio was significantly lower compared to the patients without
this treatment. In the patients treated with calcium channel blockers, TDD
per body weight was significantly lower (particularly with amlodipine) while
the tacrolimus C/D ratio was higher compared to the patients who were not
treated by them. Conclusion. A lower tacrolimus exposure was detected in
females in comparison to males. When gender differences were considered in
the context of different corticosteroid doses, faster elimination of
tacrolimus in the females was also seen, with the exception of the doses >
0.25 mg/kg. Tacrolimus exposure in the pantoprazole-treated patients was
significantly less expressed, while in patients treated with CCB amplodipine
the tacrolimus C/D ratio was significantly higher in comparison with the
patients not treated with them.
Slender women and overweight men: gender differences in the educational gradient in body weight in South Korea