The recommended initial weight-based dose of extended-release (XR) tacrolimus (Envarsus XR®) in kidney transplant recipients (KTR) is 0.14 mg/kg/day. However, no data exist regarding dosing recommendations for obese patients specifically. The aim of this study was to evaluate weight-based dosing requirements in a cohort of obese KTR who were initiated on de novo tacrolimus XR post-transplantation. The primary outcome was weight-based dosing requirements (mg/kg/day) on post-operative day (POD) 7 and 14. Of the 254 KTR, 81 (31%) were obese. The median therapeutic dose on POD7 was 0.1 vs. 0.12 vs. 0.14 mg/kg/day in the BMI > 30 kg/m , BMI 25-30 kg/m , and BMI 30 kg/m , BMI 25-30 kg/m , and BMI < 25 kg/m , respectively, (p<0.001). Therapeutic dose on POD7 and POD14 based on ideal body was similar in all cohorts (p = 0.238, p = 0.923, respectively). This finding was supported by a strong linear relationship between ideal body weight (IBW) and therapeutic dose (r = 0.929). In both obese and non-obese KTR, IBW had a stronger correlation with the therapeutic dose for tacrolimus XR. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.

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