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Colchicine levels in chronic kidney diseases and kidney transplant recipients using tacrolimus.
[familial mediterranean fever]
Tacrolimus
is
a
CYP
3
A
4
inhibitor
and
can
alter
colchicine
metabolism
.
In
this
study
,
we
aimed
to
evaluate
plasma
colchicine
levels
in
different
stages
of
kidney
disease
as
well
as
in
kidney
transplant
(
KTx
)
recipients
using
tacrolimus
.
This
study
included
six
familial
Mediterranean
fever
(
FMF
)
patients
with
normal
glomerular
filtration
rate
(
GFR
)
as
controls
,
three
patients
with
low
GFR
,
six
FMF
patients
on
hemodialysis
(
HD
)
,
and
six
FMF
patients
who
were
KTx
recipients
using
tacrolimus
.
After
a
three
-d
washout
period
,
plasma
colchicine
levels
were
measured
at
0
(
pre-dose
)
,
one
,
two
,
four
,
eight
,
and
24
Â
h
post-dose
of
1
Â
mg
oral
colchicine
.
Area
under
the
curve
0
-
24
Â
h
(
AUC
0
-
24
)
and
maximum
concentration
(
Cmax
)
were
evaluated
and
compared
between
the
groups
.
Colchicine
AUC
0
-
24
was
six-fold
higher
in
HD
(
p
Â
<
Â
0
.
001
)
and
three-fold
higher
in
KTx
recipients
(
p
Â
<
Â
0
.
001
)
when
compared
to
the
control
.
The
low
GFR
group
had
mildly
higher
AUC
0
-
24
than
the
control
group
.
Cmax
levels
were
also
higher
in
HD
(
p
Â
=
Â
0
.
011
)
and
KTx
recipient
(
p
Â
=
Â
0
.
06
)
groups
and
mildly
elevated
in
low
GFR
patients
in
comparison
with
controls
.
Colchicine
AUC
0
-
24
and
Cmax
were
significantly
increased
in
HD
patients
and
KTx
recipients
using
tacrolimus
.
Therefore
,
dose
adjustments
are
needed
to
avoid
toxicity
in
both
circumstances
.
Diseases
Validation
Diseases presenting
"kidney disease"
symptom
cystinuria
fabry disease
familial mediterranean fever
primary hyperoxaluria type 1
waldenström macroglobulinemia
This symptom has already been validated