Major Adverse Effects Associated with Tacrolimus (Fk506) Based Regimen among Saudi Kidney Transplant Patients
Ahmed S. Ali *
Department of Pharmacology, Faculty of Medicine, King Abdul-Aziz University, Jeddah, Saudi Arabia.
Marzog S. Al-Nasser
Armed Forces Hospital, Southern Region, Khamis Mushait, Saudi Arabia.
Mai A. Abdul Sattar
Department of Pharmacology, Faculty of Medicine, King Abdul-Aziz University, Jeddah, Saudi Arabia.
Huda M. Alkreathy
Department of Pharmacology, Faculty of Medicine, King Abdul-Aziz University, Jeddah, Saudi Arabia.
Mohammed N. Al-Amma
Department of Internal Medicine, Faculty of Medicine, King Abdul-Aziz University, Jeddah, Saudi Arabia.
Rayan A. Alsulaimani
Department of Pharmacology, Faculty of Medicine, King Abdul-Aziz University, Jeddah, Saudi Arabia.
Ezz H. Abdulfattah
Department of Statistics, Faculty of Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
*Author to whom correspondence should be addressed.
Abstract
Tacrolimus (Fk506)- based immunosuppressant regimen has become the cornerstone in managing kidney transplant patients (KTP) , where it has been used typically used on chronic basis. However, various adverse effects on multiple organ systems are expected and their incidence is depending on many variables including genetic and non-genetic factors. The present study aims to explore the adverse effects associated with the chronic use of Tacrolimus - based immunosuppressant regimen in Saudi kidney transplant patients (SKTP). It was performed retrospectively at Kidney Transplant Center AFHSR in Khamis Mushait (Saudi Arabia) and comprised 100 SKTP treated with Tacrolimus who were followed-up for 24 months (2012-2014).
The findings showed that the most common clinical complications associated with Tacrolimus -based regimen were as follows: nephrotoxicity (46%), hypertension (27%), new onset diabetes mellitus (18%), infections (22%) hyperlipidemia (28%) and hypomagnesaemia (85%). In addition nausea and insomnia were shown to be other common complaints .
Conclusion: The present study demonstrated a significant association between hypertension and chronic kidney rejection. as well as between nephrotoxicity and chronic rejection High trough levels of Tacrolimus were documented as a risk factor for the development of new onset diabetes mellitus (NODM) in SKTP.
Keywords: Tacrolimus, kidney transplant, side effects, therapeutic drug monitoring.