Long-lasting renal dysfunction following tacrolimus induction therapy in ulcerative colitis patients

Area of Science:

• Nephrology
• Gastroenterology
• Pharmacology

Background:

• Tacrolimus (TAC) is effective for ulcerative colitis (UC) remission induction.
• Renal dysfunction is a known complication of TAC, leading to treatment withdrawal.
• The precise impact of oral TAC on renal function in UC patients requires further elucidation.

Purpose of the Study:

• To assess the effect of oral TAC on renal function in UC patients undergoing remission induction therapy.
• To identify factors influencing TAC-induced changes in renal function.
• To compare renal function changes between elderly and non-elderly UC patients treated with TAC.

Main Methods:

• Retrospective evaluation of 55 UC patients treated with oral TAC.
• Assessment of renal function using estimated glomerular filtration rate (eGFR).
• Analysis of factors including age and serum trough levels on eGFR changes.

Main Results:

• A significant decline in eGFR was observed in nearly all patients, with a maximum decrease of 34.4% at week 11.
• eGFR decline recovered post-TAC discontinuation but did not return to baseline within two years.
• eGFR decline rate was significantly associated with patient age and peak serum TAC trough levels, and was greater in elderly patients.

Conclusions:

• Oral TAC impacts renal function in UC patients, causing a notable eGFR decline.
• Elderly patients and those with higher TAC trough levels are at greater risk for eGFR reduction.
• Close renal function monitoring, particularly in elderly patients, is crucial during and after TAC treatment for UC.