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 h post-dose of 1 mg oral colchicine . Area under the curve 0 -24 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 < 0 .001 ) and three-fold higher in KTx recipients (p < 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 = 0 .011 ) and KTx recipient (p = 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 .