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Variability of mycophenolate mofetil trough levels in stable kidney transplant patients

A Fernández1, J Martins, J J Villlafruela

  • 1Nephrology, Hospital Ramón y Cajal, Madrid, Spain. Afernandezr.hrc@salud.madrid.org

Transplantation Proceedings
|September 25, 2007
PubMed

Insights

Significant within-patient variability in mycophenolate mofetil (MMF) levels occurs in stable kidney transplant recipients. Higher MMF variability is linked to poorer kidney function and increased proteinuria, impacting treatment efficacy.

Area of Science:

  • Nephrology
  • Pharmacology
  • Immunosuppression

Background:

  • Interindividual variability in mycophenolate mofetil (MMF) pharmacokinetics is known in kidney transplant patients.
  • Within-patient variability of MMF levels in stable transplant recipients requires further investigation.

Purpose of the Study:

  • To assess the within-patient variability of trough MMF levels in stable kidney transplant patients.
  • To identify clinical and analytical factors associated with MMF level variability.

Main Methods:

  • 258 trough MMF level determinations were performed in 86 stable kidney transplant patients.
  • Patients had functioning kidneys for at least one year and a fixed MMF dose.
  • Variability was analyzed in relation to clinical factors and serum creatinine, proteinuria, and hemoglobin.

Main Results:

  • The median intraindividual variability in trough MMF levels was 65%.
  • Greater MMF level variability correlated with significantly higher serum creatinine and proteinuria.
  • No significant differences in variability were observed based on age, gender, kidney failure cause, MMF dose, or time since transplant.

Conclusions:

  • Substantial within-patient variability in trough MMF levels is present in stable kidney transplant recipients.
  • Elevated MMF variability is associated with impaired kidney function and proteinuria.
  • Monitoring MMF levels and kidney function is crucial for optimizing immunosuppression in transplant patients.

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