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Assessment of tacrolimus concentration/dose ratio as a parameter for the therapeutic monitoring in the patients subjected to kidney transplantation

dc.contributor.advisorDragojević-Simić, Viktorija
dc.contributor.otherMikov, Momir
dc.contributor.otherJakovljević, Mihajlo
dc.contributor.otherMaksić, Đoko
dc.creatorRančić, Nemanja
dc.date.accessioned2016-01-05T13:10:40Z
dc.date.available2016-01-05T13:10:40Z
dc.date.available2020-07-03T15:19:35Z
dc.date.issued2015-11-13
dc.identifier.urihttp://nardus.mpn.gov.rs/handle/123456789/3786
dc.identifier.urihttp://eteze.kg.ac.rs/application/showtheses?thesesId=2143
dc.identifier.urihttps://fedorakg.kg.ac.rs/fedora/get/o:539/bdef:Content/download
dc.description.abstractCilj ove studije je bio da se proceni uticaj pola i komedikacije na izloženost takrolimusu uz pomoć odnosa koncentracije i doze takrolimusa (C/D odnos) kod bolesnika sa transplantiranim bubregom. Korišćena je prospektivna serija slučajeva (54 pacijenta), gde je jedinica posmatranja bio kontrolni ambulantni pregled (1872) bolesnika sa transplantiranim bubregom. Bolesnici su praćeni od 2010. do 2014. godine, a ono je započeto mesec dana nakon transplantacije. Minimalna koncentracija takrolimusa u krvi (TTC) merena je uz pomoć hemiluminiscentnog mikročestičnog imunoeseja. TTC i C/D odnos su bili značajno niži kod žena u poređenju sa muškarcima. Za razliku od muškaraca, u žena je nađeno značajno povećanje dnevne doze takrolimusa (TDD) po kg telesne težine i TTC, zajedno sa povećanjem kortikosteroidne doze, koji nije bio praćen nikakvim značajnim promenama C/D odnosa. Bolesnici koji su upotrebljavali inhibitore protonske pumpe imali su značajno viši TDD po kg telesne težine i TTC, dok je C/D odnos bio značajno niži u poređenju sa bolesnicima bez ovog tretmana. Kod bolesnika koji su upotrebljavali kalcijumske blokatore TDD po kg telesne težine je bio značajno niži, dok je C/D odnos bio značajno viši u poređenju sa bolesnicima bez ovog tretmana. Kod žena je pokazano niže izlaganje takrolimusu u odnosu na muškarace. Kada su posmatrane polne razlike u odnosu na različite doze kortikosteroida, viđeno je brže eliminisanje takrolimusa kod žena, sa izuzetkom kada je doza bila > 0,25 mg/kg. Izloženost takrolimusu u prisustvu pantoprazola bila je značajno manje izražena u poređenju sa bolesnicima koji nisu bili lečeni ovim lekom.sr
dc.description.abstractThe aim of the study was to estimate the use of tacrolimus C/D ratio for the assessment of the influence of gender differences and comedication on tacrolimus exposure in renal transplant recipients. The study was designed as a prospective case series study (54 patients), in which the unit of monitoring was outpatient examination (1872) of the renal transplant patients. The patients were monitored in the period 2010- 2014, starting one month after the transplantation. Tacrolimus trough concentrations (TTC) were measured by chemiluminescence microparticles immunoassay. TTC and tacrolimus C/D ratio were significantly lower in females comparing with males. Contrary to males, in females, a significant increase of tacrolimus daily dose (TDD) per body weight and TTC, along with the corticosteroid dose increase, was not accompanied by any significant changes in tacrolimus C/D ratio. In the patients treated with proton pump inhibitors, TDD per body weight and TTC were significantly higher, while tacrolimus C/D ratio was significantly lower compared to the patients without this treatment. In the patients treated with calcium channel blockers, TDD per body weight was significantly lower, while tacrolimus C/D ratio was higher compared to the patients not treated with them. A lower tacrolimus exposure was detected in females in comparison to males. When gender differences were considered in the context of different corticosteroid doses, faster elimination of tacrolimus in females was also seen, with the exception of the doses > 0.25mg/kg. Tacrolimus exposure in pantoprazole-treated patients was significantly less expressed in comparison with the patients not treated with them.en
dc.formatapplication/pdf
dc.languagesr
dc.publisherУниверзитет у Крагујевцу, Факултет медицинских наукаsr
dc.relationinfo:eu-repo/grantAgreement/MESTD/Basic Research (BR or ON)/175014/RS//
dc.rightsopenAccessen
dc.sourceУниверзитет у Крагујевцуsr
dc.subjectTakrolimussr
dc.subjectTacrolimusen
dc.subjecttransplantacija bubregasr
dc.subjectpolsr
dc.subjectkomedikacijasr
dc.subjectodnos koncentracije i dozesr
dc.subjectrenal transplantationen
dc.subjectgenderen
dc.subjectcomedicationen
dc.subjectconcentration/dose ratioen
dc.titleProcena odnosa koncentracija/doza takrolimusa kao parametra za terapijski monitoring u pacijenata podvrgnutih transplantaciji bubregasr
dc.titleAssessment of tacrolimus concentration/dose ratio as a parameter for the therapeutic monitoring in the patients subjected to kidney transplantationen
dc.typedoctoralThesisen
dc.rights.licenseBY-NC-ND
dcterms.abstractДрагојевић-Симић, Викторија; Миков, Момир; Јаковљевић, Михајло; Максић, Ђоко; Ранчић, Немања; Процена односа концентрација/доза такролимуса као параметра за терапијски мониторинг у пацијената подвргнутих трансплантацији бубрега; Процена односа концентрација/доза такролимуса као параметра за терапијски мониторинг у пацијената подвргнутих трансплантацији бубрега;
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/49934/Izvestaj Nemanja Rancic MEDICINSKI.pdf
dc.identifier.fulltexthttp://nardus.mpn.gov.rs/bitstream/id/49933/Disertacija.pdf


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