Evidence mapPaperPMID 41766896Full record

ArticleFrontiers in immunology2026

Elevated tacrolimus exposure variability predicts transplant renal insufficiency.

Yue Zhao, Ying-Xin Zhao, Di Zhao, Wei-Li Wang, Qian Wang

Abstract read
In one paragraph

Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Yue Zhao *Department of Pharmacy, the First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China.
Ying-Xin Zhao *Department of Pharmacy, Daping Hospital, Army Medical University (Third Military Medical University), Chongqing, China.
Di ZhaoDepartment of Pharmacy, the First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China.
Wei-Li WangDepartment of Nephrology, the First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China.
Qian WangDepartment of Pharmacy, the First Affiliated Hospital of Army Medical University (Third Military Medical University), Chongqing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Optimizing immunosuppression based on immunological risk profiles remains the preferred regimen for improving long-term graft outcomes after renal transplantation. Tacrolimus (TAC), the cornerstone drug of the calcineurin inhibitors, is currently the most commonly used immunosuppressant for renal transplantation. Under-exposure can lead to rejection events, while overexposure has been shown to cause drug-related renal injury. This study aims to assess the impact of TAC exposure on graft renal function to identify high-risk individuals of post-transplantation. Methods: The present study employed a single-center retrospective cohort design to enroll adult recipients who underwent allogeneic kidney transplantation from 1 January 2019 to 31 December 2023. Cox regression analysis was used to analyze the independent risk effects of exposure parameters, which included mean, median, standard deviation (STD) and coefficient of variation (CV). Hereafter, the Kaplan-Meier method was applied to perform the survival analysis of stabilized graft renal function. Results: 69 cases (19.22%) in the study cohort developed graft renal insufficiency. And a STD of TAC target trough concentration≥5 was associated with a 4.55-fold elevated risk (95% CI 1.60-12.95, p = 0.004). Recipients in the higher CV had an increased risk of graft renal insufficiency in comparison with those in low CV tertile. As indicated by the survival analysis curves, it was determined that TAC mean trough concentrations >8 ng/mL, CV>0.5 and TTR<0.3 were associated with a higher risk of graft renal insufficiency. Conclusion: Higher TAC trough concentrations, higher CV, and lower TTR post-transplantation significantly increases the risk of transplant renal insufficiency. Identifying these high-risk transplant recipients, correcting potentially influential factors and keeping TAC within recommended concentrations will significantly improve the outcomes and survival of renal transplant recipients.

Indexed as

Graft RejectionImmunosuppressive AgentsKidney TransplantationRenal InsufficiencyTacrolimusAdultCalcineurin InhibitorsFemaleGraft SurvivalHumansMaleMiddle AgedRetrospective StudiesRisk FactorsCalcineurin InhibitorsImmunosuppressive AgentsTacrolimuscoefficient of variationpredictiontacrolimustime in therapeutic rangetransplant renal insufficiency

Identifiers

PMID41766896
PMCPMC12945822

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.