Tacrolimus nephrotoxicity: beware of the association of diarrhea, drug interaction and pharmacogenetics.
Pediatr Nephrol
; 25(5): 965-9, 2010 May.
Article
em En
| MEDLINE
| ID: mdl-20091056
ABSTRACT
Tacrolimus is known to potentially lead to adverse events in recipients with diarrhoea and/or calcium channel blocker (CCB) co-administration. We report a renal transplant recipient who suffered from severe nephrotoxicity related to a toxic tacrolimus trough concentration in both conditions, diarrhoea and CCB co-administration, and with genotyped CYP3A system and P-glycoprotein (P-gp) polymorphisms. To our knowledge, this is the first case to be investigated for such polymorphisms. Clinicians should be reminded of the possibility of highly increased levels of tacrolimus in situations of diarrhoea and/or co-administration of CCBs. It also highlights the key role in tacrolimus pharmacokinetics of the CYP3A system and P-gp polymorphisms, and their influence in high-risk situations when enzyme activity is already affected by enterocyte damage due to diarrhoea and CCB competition.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Bloqueadores dos Canais de Cálcio
/
Transplante de Rim
/
Tacrolimo
/
Membro 1 da Subfamília B de Cassetes de Ligação de ATP
/
Sistema Enzimático do Citocromo P-450
/
Diarreia
/
Injúria Renal Aguda
/
Imunossupressores
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Humans
/
Male
Idioma:
En
Revista:
Pediatr Nephrol
Assunto da revista:
NEFROLOGIA
/
PEDIATRIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
França