ASSA13-14-16 Influence of Amlodipine on Tacrolimus Concentration/Dose in Hypertension Patients During Perioperative Period After Kidney Transplantation

Objective To investigate the prevalence of hypertension during perioperative period after kidney transplantation, observe the influence of amlodipine on tacrolimus steady-state concentration/dose (ng·mg-1·Kg, dose imply Dose/Body Weight). Methods Select kidney transplantation patients using Tacrolimus + Mycophenolate Mofetil (Or Mycophenolate sodium enteric-coated tablets) + Glucocorticoid as triple immunosuppressive therapy during May 2012 and December 2012. After in vivo tacrolimus reach the steady-state, collect the peripheral vein blood just before and 0.5 h, 1 h, 2 h, 8 h, 12 h after administration to detect the blood concentration of tacrolimus. After sampling, hypertension patients will be given amlodipine 5mg/d (140mmHg ≤ SBP ≤ 150mmHg) or 10mg/d (SBP ≥ 160mmHg). If blood pressure is higher than normal before this, other kinds of antihypertensive medicine except CCB should be given to control it. One week after amlodipine medication, collect the peripheral vein blood just before and 0.5 h, 1 h, 2 h, 8 h, 12 h after administration to detect the blood concentration of tacrolimus. Compare the tacrolimus concentration/dose (C/D) of different time points before and after amlodipine combination, analyse the influence of amlodipine on tacrolimus. Results There are 60 (43 male, 17 female) patients included, 55 (40 male, 15 female) hypertension patients among them. 31 (19 male, 12 female) patients complete the sampling. Tacrolimus C/Ds of 0 h, 0.5 h, 1 h, 2 h, 8 h and 12 h before and after amlodipine combination were 57.47 ± 7.35 and 72.91 ± 12.29 (p = 0.136), 175.17 ± 31.19 and 132.44 ± 28.65 (p = 0.144), 167.61 ± 17.52 and 200.01 ± 35.44 (p = 0.208), 119.63 ± 14.40 and 195.89 ± 34.66 (p = 0.018), 63.75 ± 7.99 and 92.00 ± 11.89 (p = 0.006), 54.82 ± 9.17 and 79.92 ± 19.23 (p = 0.072), respectively. C/Ds of each time point elevated except 0.5 h after amlodipine medication, especially 2 h and 8 h had significant difference. Conclusions The incidence of hypertension during perioperative period after kidney transplantation is 92%. Combine tacrolimus with amlodipine in these patients will significantly increase its C/D. We should be alert when these two drugs combined in clinical.