THỰC TRẠNG SỬ DỤNG THUỐC VÀ THEO DÕI NỒNG ĐỘ TACROLIMUS TRÊN BỆNH NHÂN GHÉP THẬN TẠI BỆNH VIỆN QUÂN Y 175

Abstract

Purposes: To evaluate the use of Tacrolimus (TAC) and therapeutic drug monitoring in kidney transplant patients. Subjects: 72 kidney transplant patients at Military Hospital 175. Methods: A retrospective case series study conducted from July 2023 to November 2025. Results: All patients were treated according to the T-MMF-P regimen, with 93.1% receiving Basiliximab induction therapy before transplantation. After transplantation, renal function improved markedly, with eGFR increasing from 7.5 to 67.95 mL/min/1.73m². The incidence of acute rejection was low (1.39%), while UTI occurred at a relatively high rate (25%). The C₀ gradually decreased from 9.04 to 6.27 ng/mL after 12 months, without a significant impact on eGFR (p = 0.554). The median IPV of Tacrolimus concentration was 25.24%, and 64% of patients had a CV% greater than 20%, which may be associated with an increased risk of rejection or toxicity, potentially due to poor adherence, comorbidities, or drug interactions that elevate drug levels. The MLVI/SD value was 1.74 ng/mL (range: 0.41-8.29), indicating considerable fluctuation in drug concentration. Conclusion: All patients received the T-MMF-P regimen in accordance with the KDIGO 2020 recommendations, showing a marked improvement in renal function with a median eGFR of 67.95 mL/min/1.73m² and a low rate of acute rejection. However, IPV remained high, with a median CV% of 25.24% and 64% of patients having CV% > 20%, which increases the risk of rejection and toxicity. Strengthened therapeutic drug monitoring and optimization of the regimen based on C₀ levels are necessary to improve long-term kidney transplant outcomes.