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KMID : 0811820140180010018
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Journal of Korean Society of Pediatric Nephrology
2014 Volume.18 No. 1 p.18 ~ p.23
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Effects of Age and Sex on the Pharmacokinetics of Tacrolimus during Pediatric Kidney Transplantation: A Single Center Study
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Choe Jae-Young
Jang Kyung-Mi
Hwang Young-Ju
Choi Bong-Seok
Park Jong-Kwang
Yoon Young-Ran
Kim Chan-Duck
Cho Min-Hyun
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Abstract
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Purpose: The pharmacokinetics of tacrolimus, one of the most widely usedimmunosuppressive drugs, are known to vary by sex, age, and ethnicity duringpediatric transplantation. This study assessed the pharmacokinetic characteristicsand associated factors of tacrolimus in Korean children receiving a kidneytransplant.
Methods: We retrospectively reviewed the pharmacokinetic data (therapeuticdose, trough level, clearance, and half-life) of 9 children who were given tacrolimusas one of their initial immunosuppressive drugs after kidney transplantation. Inaddition, we compared the findings to data from 10 adult kidney transplant recipients.
Results: The mean age of our pediatric patients was 13.9 years, and the maleto-female ratio was 4:5. The mean dose of tacrolimus was 0.19±0.14 mg/kg/day. The mean dose of tacrolimus for males was 0.23±0.12 mg/kg/day, which wassignificantly higher than the dose for females (0.16±0.14 mg/kg/day). The troughlevel was not significantly different between both groups. The clearance rateof tacrolimus for males was also significantly higher than females. Although thedosage of tacrolimus for patients over the age of 12 years was lower (0.18±0.13 vs.
0.21±0.16 mg/kg/day) and the trough level was higher (8.2±4.5 vs. 7.2±4.2 mg/mL) than that for patients under the age of 12 years, there was no significantdifference between them. However, there were significant differences betweenchildren and adults in dose, clearance, and half-life of tacrolimus.
Conclusion: Out study suggests that the pharmacokinetics of tacrolimus tendsto vary with sex and age. Therefore, large-scale prospective studies are requiredto verify the proper therapeutic dosage of tacrolimus in Korean children.
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KEYWORD
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Tacrolimus, Kidney transplantation, Pharmacokinetics, Children
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