Tacrolimus IPV Group Membership Does Not Consistently Track With Electronically Monitored or Self-reported Adherence in Adolescent and Young Adult Kidney Transplant Recipients

作者：Cyd K. Eaton, Cozumel S. Pruette, Kristin A. Riekert, Nazanin Yousefzadeh, Ahna L. H. Pai, Sandra Amaral, Vikas R. Dharnidharka, Bärbel Knaüper, Jodi M. Smith, Susan L. Furth, Bethany J. Foster · 发表于：Transplantation Direct · 年份：2025 · DOI：10.1097/txd.0000000000001806 · 被引用次数：3 · 研究领域：Renal Transplantation Outcomes and Treatments、Dialysis and Renal Disease Management、Transplantation: Methods and Outcomes

Background. High intrapatient variability (IPV) of tacrolimus trough concentrations (SD ≥ 2, coefficient of variation (CV%) ≥ 30) is associated with rejection and graft loss and may indicate nonadherence. However, the association between tacrolimus IPV and electronically monitored or self-reported adherence is unknown. Methods. This secondary analysis of the TAKE-IT (Teen Adherence in Kidney Transplant Effectiveness of Intervention Trial) compared electronically monitored and self-reported adherence between participants with high and low tacrolimus IPV among 103 adolescent and young adult kidney transplant recipients (mean age = 15.18 y, 59% male, 60% White, 65% >1-y posttransplant). Results. Electronically monitored daily taking and timing adherence were not significantly associated with tacrolimus IPV group in binomial generalized linear mixed effects models: Participants with tacrolimus SD ≥ 2 or CV% ≥ 30 were no less likely to take each daily dose than those below these cutoffs (SD < versus ≥ 2: odds ratio [OR]; 0.84, 95% confidence interval [CI], 0.48-1.47; P = 0.54 and CV% < versus ≥ 30: OR, 0.72; 95% CI, 0.43-1.21; P = 0.22). Participants with tacrolimus SD ≥ 2 or CV% ≥ 30 were no less likely to take each daily dose on time than those below these cutoffs (SD < versus ≥ 2: OR, 0.70; 95% CI, 0.40-1.23; P = 0.21 and CV% < versus ≥ 30: OR, 0.68; 95% CI, 0.40-1.16; P = 0.15). Electronically monitored averages of doses taken, doses taken early/late, and differ...