| Abstract | CILJ ISTRAŽIVANJA: Istražiti varijabilnost koncentracije imunosupresivnih (IS) lijekova u krvi tijekom jedne godine (2017.) u bolesnika s bubrežnim presatkom u Kliničkom bolničkom centru Osijek (KBCO). NACRT ISTRAŽIVANJA: Kohortno povijesno istraživanje. ISPITANICI I POSTUPCI: U istraživanje je uključeno 89 bolesnika (54% muškaraca) s funkcionalnim bubrežnim presatkom, transplantiranih u KBCO. Medijan dobi bolesnika bio je 58 godina s interkvartilnim rasponom od 50 do 64 (IQR, od eng.interquartile range). Iz medicinskih zapisa prikupljeni su podaci o koncentraciji IS lijekova u krvi i o kreatininemiji tijekom 2017. godine, a varijabilnost koncentracije izračunata je prema formuli (standardna devijacija/aritmetička sredina) x 100. Podaci su obrađeni u SPSS-u (inačica 16.0, SPSS Inc.,Chicago, IL, SAD). REZULTATI: Varijabilnost koncentracije takrolimusa (TAK) bila je 23,36%, ciklosporina (CSA) 17,45%, everolimusa 21,7% i sirolimusa 31,29%. Varijabilnost Prografa bila je 26,2%, Advagrafa 18,6% i Envarsusa 38,5%. U trenutku istraživanja, TAK je primalo 57% bolesnika, a CSA 30% bolesnika. Od preparata TAK-a, najviše bolesnika primalo je Advagraf(34%). Medijan mjerenja koncentracije za TAK, CSA i everolimus bio je 4, a medijan mjerenja koncentracije za sirolimus bio je 5. Medijan kreatininemije bio je 124,75, s varijabilnošću 7,51%. Nije bilo korelacije između varijabilnosti koncentracija IS lijekova i varijabilnosti kreatininemije. ZAKLJUČAK: Najveću varijabilnost koncentracije lijeka u naših bolesnika imao je sirolimus, a najmanju CSA. Envarsus je imao najveću varijabilnost među preparatima takrolimusa, moguće zbog toga što je taj lijek u toj godini tek uveden.Broj mjerenja koncentracije lijekova u krvi u KBCO-u vrlo jeraznolik. |
| Abstract (english) | AIMS: The aim of this study was to explore variability in concentration of immunosuppressive (IS) drugs in blood during the period of one year (2017) in patients with kidney transplant in Clinical Hospital Centre Osijek (CHCO). DESIGN: Historical cohort study. PATIENTS AND METHODS: The study included 89 patients (54 % male) with functional kidney transplant which were transplanted in KBCO. Median age of the patients was 58 years with interquartile range of 50 to 64. Data on concentrations of IS drugs and creatininemia were taken from medical records and statistically analyzed using SPSS (version 16.0).Variability in concentration was calculated according to the formula (standard deviation/ mean) x 100. RESULTS: Variability in concentration of tacrolimus (TAC) was 23.35%, of cyclosporine (CSA) 17.45%, of everolimus 21.7% and of sirolimus 31.29%. Variability in concentration of Prograf was 26.2%, of Advagraf 18.6 % and of Envarsus 38.5%. At the time of the study TAC was taken by 57% of the patients and CSA by 30% of the patients. Median measurement of concentration for TAC, CSA and everolimus was 4 and for sirolimus 5. Median creatininemia was 124.75 with variability of 7.51%. There was no correlation between variability in concentration of IS drugs and variability in creatininemia. CONCLUSION: The highest variability in concentration in the patients had sirolimus, and the lowest CSA. Envarsus had the highest variability among preparations of TAC, possibly due to the fact that Envarsus was the most often introduced in that year. The number of blood drug concentration measurements in KBCO is very diverse. |
