Immediate-Release versus Extended-Release Tacrolimus: Comparing Blood Pressure Control in Kidney Transplant...

Area of Science:

• Nephrology
• Pharmacology
• Immunology

Background:

• Hypertension is a frequent complication in kidney transplant recipients treated with tacrolimus (Tac).
• Long-term blood pressure control differences between immediate-release tacrolimus (Tac IR) and extended-release tacrolimus (Tac ER) are not well-established.
• Tacrolimus is a primary immunosuppressant for preventing kidney transplant rejection.

Purpose of the Study:

• To compare the impact of Tac IR versus Tac ER on long-term blood pressure control in kidney transplant recipients.
• To evaluate differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertensive crisis between Tac IR and Tac ER.
• To analyze the effect of tacrolimus formulation on blood pressure management post-kidney transplantation.

Main Methods:

• A retrospective cohort study analyzed 654 kidney transplant recipients.
• Longitudinal data on SBP, DBP, and hypertensive crisis were collected for patients on Tac IR or Tac ER.
• A marginal structural linear mixed-effects model was used to assess blood pressure control.

Main Results:

• No significant differences were observed in longitudinal systolic blood pressure (p = 0.386) or diastolic blood pressure (p = 0.797) between Tac IR and Tac ER groups.
• The study included patients with a mean age around 50-52 years, with similar gender distribution.
• Black patients had higher odds of receiving Tac ER, even after adjusting for baseline characteristics.

Conclusions:

• Extended-release tacrolimus (Tac ER) does not lead to different chronic systolic or diastolic blood pressure control compared to immediate-release tacrolimus (Tac IR) in kidney transplant recipients.
• The choice between Tac IR and Tac ER may not significantly impact long-term blood pressure management in this population.
• Further research could explore other potential differences or patient subgroups.