RESULTS OF TREATMENT OF KIDNEY RECIPIENTS AGAINST THE BACKGROUND OF MINIMIZATION OF IMMUNOSUPPRESSIVE THERAPY

Parabina Elena V., Mironov Alexey Alexandrovich, Myakotnykh Maxim Nikolaevich

The aim is to study the effect of immunosuppressive therapy based on reducing standard dosages and target concentrations of tacrolimus on the results of the postoperative period in recipients with a transplanted kidney. Materials and methods. The study included 89 kidney recipients. In accordance with the purpose and objectives of the study, the recipients were divided into two groups. The first group (control) included 34 patients receiving standard immunosuppressive therapy with calcineurin inhibitors (tacrolimus prolonged action) in combination with standard dosages of mycophenolic acid. The target concentration of tacrolimus in this group was 7-8 ng/ml. The second group (main group) included 55 patients who received immunosuppressive therapy according to the tacrolimus prolonged-acting regimen in reduced dosages in combination with mycophenolic acid. The target concentration of tacrolimus in this group was 5-6 ng/ml. Both groups were comparable in gender, age, type and duration of renal replacement therapy, as well as in the main diagnosis that led to chronic renal failure. Results. During the study, it was revealed that minimizing immunosuppressive therapy leads to an improvement in long-term results of transplantation. In the late postoperative period, in the group with reduced doses and target values of tacrolimus concentration, the creatinine level remained significantly lower than in the control subgroup. There was also a significant difference in glomerular filtration rate - in the study group it was significantly higher by 20% than in the control group. A decrease in the target concentrations of tacrolimus in the postoperative period significantly led to a decrease in the frequency of dose-dependent side effects, which subsequently led to a significant improvement in the quality of life of recipients in the control group.

Keywords:kidney transplantation, immunosuppressive therapy, tacrolimus, chronic renal failure.