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The objectives of this study were to summarize the existing literature by meta\u2010analysis and evaluate the impact of food composition on 24\u2010hour pharmacokinetics in pediatric kidney transplant recipients. For the meta\u2010analysis, 10 studies involving 253 individuals were included. The pooled effect sizes demonstrated significant differences in area under the concentration\u2013time curve from time 0 to 12 hours (standardized mean difference [SMD], 0.27; 95% confidence interval [CI], 0.03\u20100.52) and maximum concentration (SMD, 0.75; 95% CI, 0.35\u20101.15) between morning and evening dose administration. However, there was significant between\u2010study heterogeneity that was explained by food exposure. The effect size for minimum concentration was not significantly different overall (SMD, \u22120.09; 95% CI, \u22120.27 to 0.09) or across the food exposure subgroups. 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The available data suggest food intake is the major driver of diurnal variation in tacrolimus exposure, but the associated changes are not reflected by trough concentrations alone.<\/jats:p>","DOI":"10.1002\/jcph.2352","type":"journal-article","created":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T07:17:07Z","timestamp":1695453427000},"page":"334-344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Comprehensive Mixed\u2010Method Approach to Characterize the Source of Diurnal Tacrolimus Exposure Variability in Children: Systematic Review, Meta\u2010analysis, and Application to an Existing Data Set"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4310-4697","authenticated-orcid":false,"given":"Abbie D.","family":"Leino","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy College of Pharmacy University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8416-7905","authenticated-orcid":false,"given":"John C.","family":"Magee","sequence":"additional","affiliation":[{"name":"Department of Surgery Medical School University of Michigan Ann Arbor MI USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B.","family":"Kershaw","sequence":"additional","affiliation":[{"name":"Department of Pediatrics C.S. 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