Medication use profile in renal transplant patients - Impacts on length of stay

Authors

DOI:

https://doi.org/10.21527/2176-7114.2026.51.16759

Keywords:

Drug therapy, Kidney transplantation, Length of stay, Immunosuppressive agents, Drug interactions

Abstract

Aim: to evaluate the impact of the medication use profile on the occurrence of complications in kidney transplant patients at a university hospital in Brazil. Methodology: retrospective study using data from renal transplant patients' medical records (n = 182). Interactions between immunosuppressants and other prescribed drugs were analyzed. Results: 68.7% of the patients were male. The average age was 48.15 years. The most frequent comorbidities were hypertension (62.6%) and diabetes (33.5%). The average hospital stay was 21.68 days. 104 drugs were used, 9.71 per patient. As an initial immunosuppressive regimen, 45.1% were prescribed tacrolimus + mycophenolate, 54.4% tacrolimus + sirolimus, and 0.5% mycophenolate + sirolimus. The drugs prescribed with probable interaction with tacrolimus were omeprazole (88.46%), amlodipine (48.90%), and isoniazid (37.91%); with sirolimus, they were amlodipine (29.67%) and isoniazid (20.33%), and with mycophenolate, omeprazole (39.01%). Prescribing a greater number of drugs increased hospitalization time by up to 8.5 days, while the use of calcium channel blockers predicted a reduction of approximately 5 days. Conclusion: The profile of medication use showed that drug prescriptions can have an impact on hospital stay.

References

1. Galato D, Simões IG, Soares LS da S. Avaliação do Índice de Complexidade da Farmacoterapia em Pacientes de um Ambulatório de Transplante Renal. Brazilian Journal of Transplantation. 2022 Jun 23;25(2). DOI: https://doi.org/10.53855/bjt.v25i2.448_pt

2. Medeiros LKA de, Borba AK de OT, Sette GCS, Maciel C de G, Quirino AP de S, Pereira MPL, et al. FATORES ASSOCIADOS À ADESÃO A TERAPIA IMUNOSSUPRESSORA EM INDIVÍDUOS TRANSPLANTADOS RENAIS. Enfermagem em Foco. 2022 Dec 23;13. DOI: https://doi.org/10.21675/2357-707x.2022.v13.e-202244

3. Associação Brasileira de Transplante de Órgãos. Dimensionamento dos Transplantes no Brasil e em cada estado (2016-2023) [Internet]. 2023. https://doi.org/10.000

4. Szumilas K, Wilk A, Wiśniewski P, Gimpel A, Dziedziejko V, Kipp M, et al. Current Status Regarding Immunosuppressive Treatment in Patients after Renal Transplantation. Int J Mol Sci. 2023 Jun 1; 24(12). DOI: https://doi.org/10.3390/IJMS241210301

5. Cardoso Martins BC, Fernandes da Costa IH, Chaves EF, Firmino PYM, Castelo Branco Camurca Fernandes PF, Fonteles MM de F. Medication Regimen Complexity Index After Kidney Transplant in Fortaleza, Brazil. Journal of Young Pharmacists. 2023 Apr 17;15(2):338–44. DOI: https://doi.org/10.5530/jyp.2023.15.45

6. Ministério da Saúde. PROTOCOLO CLÍNICO E DIRETRIZES TERAPÊUTICAS-IMUNOSSUPRESSÃO EM TRANSPLANTE RENAL. 2011.

7. Batista Marquito A, Sanders Pinheiro H, Maria da Silva Fernandes N, Baumgratz de Paula R. Avaliação da farmacoterapia na doença renal crônica: validação do instrumento PAIR para uso no Brasil. Brazilian Journal of Nephrology [Internet]. 2020; DOI: https://doi.org/10.1590/2175-8239

8. Crews DC, Bello AK, Saadi G. Editorial do Dia Mundial do Rim 2019 – impacto, acesso e disparidades na doença renal. Brazilian Journal of Nephrology. 2019 Mar 1;41(1):1–9. DOI: https://doi.org/10.1590/2175-8239-JBN-2018-0224

9. Oosting IJ, Colombijn JMT, Kaasenbrood L, Liabeuf S, Laville SM, Hooft L, et al. Polypharmacy in Patients with CKD: A Systematic Review and Meta-Analysis. Kidney360. 2024 Jun 1;5(6):841–50. DOI: https://doi.org/10.34067/KID.0000000000000447

10. Moradi O, Karimzadeh I, Davani-Davari D, Shafiekhani M, Sagheb MM, Raees-Jalali GA. Drug-Drug Interactions among Kidney Transplant Recipients in The Outpatient Setting. Int J Organ Transplant Med. 2020;

11. Moura Fraga J, Rodrigues da Silva A, Souza de Oliveira AR, Soares Barbosa A, Melo Girão C, Borges Studart RM. Fatores que influenciam o tempo de internação no transplante renal. Saúde Coletiva (Barueri). 2021 Oct 13;11(68):7617–28. DOI: https://doi.org/10.36489/saudecoletiva.2021v11i68p7617-7628

12. Turnbull AJ, Donaghy E, Salisbury L, Ramsay P, Rattray J, Walsh T, et al. Polypharmacy and emergency readmission to hospital after critical illness: a population-level cohort study. BJA: British Journal of Anaesthesia. 2020 Feb 1;126(2):415. DOI: https://doi.org/10.1016/J.BJA.2020.09.035

13. Garcia CD, Garcia VD, Pereira JD. Manual de Doação e Transplantes. 2017.

14. Gomes RM, Barbosa WB, De Assis Acurcio F, Guerra Júnior AA. Dezesseis anos de transplante renal: uma coorte aberta no sistema único de saúde no Brasil. JORNAL DE ASSISTÊNCIA FARMACÊUTICA E FARMACOECONOMIA. 2024 Feb 21;9(1). DOI: https://doi.org/10.22563/2525-7323.2024.v9.n.1.p.5-17

15. Katz-Greenberg G, Shah S. Sex and Gender Differences in Kidney Transplantation. Vol. 42, Seminars in Nephrology. W.B. Saunders; 2022. p. 219–29. DOI: https://doi.org/10.1016/j.semnephrol.2022.04.011

16. Gouvêa E de CDP, Szwarcwald CL, Damacena GN, de Moura L. Self-report of medical diagnosis of chronic kidney disease: prevalence and characteristics in the Brazilian adult population, National Health Survey 2013 and 2019. Epidemiologia e Servicos de Saude. 2022;31(Spe1). DOI: https://doi.org/10.1590/SS2237-9622202200017

17. Charles C, Ferris AH. Chronic Kidney Disease. Primary Care: Clinics in Office Practice. 2020 Dec 1;47(4):585–95. DOI: https://doi.org/10.1016/J.POP.2020.08.001

18. Sistema de Dados Renais dos Estados Unidos - USRDS - NIDDK https://www.niddk.nih.gov/about-niddk/strategic-plans-reports/usrds

19. da Rocha KT, Figueiredo AE, da Rocha KT, Figueiredo AE. Letramento em Saúde: avaliação de pacientes em terapia renal substitutiva. Enfermería Nefrológica. 2019;22(4):388–97. DOI: https://doi.org/10.4321/S2254-28842019000400005

20. Melilli E, Díaz MI, Gomis-Pastor M, González E, Gutierrez-Dalmau A, Nuño EI, et al. Predictors of Treatment Adherence in Kidney Transplant Patients: A Systematic Review of the Literature. J Clin Med. 2025 Mar 1;14(5). DOI: https://doi.org/10.3390/JCM14051622

21. Kosoku A, Iwai T, Kabei K, Nishide S, Maeda K, Kumada N, et al. Hyperpolypharmacy and Frailty in Kidney Transplant Recipients. Transplant Proc. 2022 Mar 1;54(2):367–73. DOI: https://doi.org/10.1016/j.transproceed.2021.11.026

22. Rostaing L, Jouve T, Terrec F, Malvezzi P, Noble J. Adverse Drug Events after Kidney Transplantation. Journal of Personalized Medicine 2023, Vol 13, Page 1706 [Internet]. 2023 Dec 14;13(12):1706. DOI: https://doi.org/10.3390/JPM13121706

23. Cheng CY, Feng YT, Wang HY. Incidence and relative risk factors in posttransplant diabetes mellitus patients: a retrospective cohort study. Korean Journal of Transplantation. 2020 Dec 12;34(4):213. DOI: https://doi.org/10.4285/KJT.20.0026

24. Kardas P, Lichwierowicz A, Urbański F, Chudzyńska E, Czech M, Kardas G. Prevalence of Chronic Polypharmacy in Community-Dwelling Elderly People in Poland: Analysis of National Real-World Database Helps to Identify High Risk Group. Front Pharmacol. 2021 Nov 18;12. DOI: https://doi.org/10.3389/FPHAR.2021.739740

25. Passos MMB dos, Barbosa GS, Costa MR da. Análises das autorizações de procedimentos de alta complexidade de medicamentos para pacientes transplantados renais do Estado do Rio de Janeiro. Research, Society and Development. 2021 May 17;10(5):e3110514522. DOI: https://doi.org/10.33448/rsd-v10i5.14522

26. Tedesco-Silva H, del Carmen Rial M, Cruz Santiago J, Mazzali M, Pacheco-Silva A, Torres R. Optimizing the clinical utility of sirolimus-based immunosuppression for kidney transplantation. Clin Transplant [Internet]. 2019 Feb 1; 33(2). DOI: https://doi.org/10.1111/CTR.13464

27. Loutradis C, Sarafidis P, Marinaki S, Berry M, Borrows R, Sharif A, et al. Role of hypertension in kidney transplant recipients. Vol. 35, Journal of Human Hypertension. Springer Nature; 2021. p. 958–69. DOI: https://doi.org/10.1038/s41371-021-00540-5

28. Seeman T, Feber J. Should ACE inhibitors or calcium channel blockers be used for post-transplant hypertension? Pediatric Nephrology. 2021 Mar 1;36(3):539–49. DOI: https://doi.org/10.1007/S00467-020-04485-8

29. Moore KH, Clemmer JS. Questioning the renoprotective role of L-type calcium channel blockers in chronic kidney disease using physiological modeling. Am J Physiol Renal Physiol. 2021 Oct 1;321(4):F548–57. DOI: https://doi.org/10.1152/AJPRENAL.00233.2021

30. Fukuba N, Nishida M, Hayashi M, Furukawa N, Ishitobi H, Nagaoka M, et al. The Relationship Between Polypharmacy and Hospital-stay Duration: A Retrospective Study. Cureus. 2020 Mar 14;12(3). DOI: https://doi.org/10.7759/CUREUS.7267

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Published

2026-03-02

How to Cite

Teixeira, I. M. M., Pinheiro, N. M. L., Duque, B. R., da Costa, M. D. R., de Oliveira, A. B., Ferreira Emiliano, J. H., … Sampaio, T. L. (2026). Medication use profile in renal transplant patients - Impacts on length of stay. Revista Contexto & Saúde, 26(51), e16759. https://doi.org/10.21527/2176-7114.2026.51.16759

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ORIGINAL ARTICLE