Scheel, Jennifer, Reber, Sandra, Stoessel, Lisa, Waldmann, Elisabeth ORCID: 0000-0003-3983-9957, Jank, Sabine, Eckardt, Kai-Uwe, Grundmann, Franziska, Vitinius, Frank, de Zwaan, Martina, Bertram, Anna and Erim, Yesim (2017). Patient-reported non-adherence and immunosuppressant trough levels are associated with rejection after renal transplantation. BMC Nephrol., 18. LONDON: BMC. ISSN 1471-2369

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Abstract

Background: Different measures of non-adherence to immunosuppressant (IS) medication have been found to be associated with rejection episodes after successful transplantation. The aim of the current study was to investigate whether graft rejection after renal transplantation is associated with patient-reported IS medication non-adherence and IS trough level variables (IS trough level variability and percentage of sub-therapeutic IS trough levels). Methods: Patient-reported non-adherence, IS trough level variability, percentage of sub-therapeutic IS trough levels, and acute biopsy-proven late allograft rejections were assessed in 267 adult renal transplant recipients who were = 12 months post-transplantation. Results: The rate of rejection was 13.5%. IS trough level variability, percentage of sub-therapeutic IS trough levels as well as patient-reported non-adherence were all significantly and positively associated with rejection, but not with each other. Logistic regression analyses revealed that only the percentage of sub-therapeutic IS trough levels and age at transplantation remained significantly associated with rejection. Conclusions: Particularly, the percentage of sub-therapeutic IS trough levels is associated with acute rejections after kidney transplantation whereas IS trough level variability and patient-reported non-adherence seem to be of subordinate importance. Patient-reported non-adherence and IS trough level variables were not correlated; thus, non-adherence should always be measured in a multi-methodological approach. Further research concerning the best combination of non-adherence measures is needed.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Scheel, JenniferUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reber, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stoessel, LisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Waldmann, ElisabethUNSPECIFIEDorcid.org/0000-0003-3983-9957UNSPECIFIED
Jank, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eckardt, Kai-UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grundmann, FranziskaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vitinius, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
de Zwaan, MartinaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bertram, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Erim, YesimUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-236245
DOI: 10.1186/s12882-017-0517-6
Journal or Publication Title: BMC Nephrol.
Volume: 18
Date: 2017
Publisher: BMC
Place of Publication: LONDON
ISSN: 1471-2369
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SOLID-ORGAN TRANSPLANTATION; KIDNEY-TRANSPLANTATION; MEDICATION ADHERENCE; RISK-FACTORS; SELF-REPORT; GRAFT LOSS; RECIPIENTS; VARIABILITY; TACROLIMUS; IMPACTMultiple languages
Urology & NephrologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/23624

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