{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:46:03Z","timestamp":1785735963262,"version":"3.56.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Post-transplant hyperuricemia (PTHU) is a frequent and clinically significant metabolic complication among kidney transplant recipients. Current models lack personalized pre-transplant prevention strategies, and few studies define the optimal tacrolimus level for PTHU prevention. To address this unmet need, we developed and evaluated an integrated digital health tool consisting of a pre-operative risk-prediction algorithm and a post-operative tacrolimus dosing management module.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We enrolled 195 kidney transplant recipients. Pre-transplantation laboratory assessments and serial tacrolimus blood-concentration (Ctac) measurements longitudinally were conducted, while documenting adverse events. Logistic regression was used to identify the risk factors, and then incorporated into a nomogram. A subsequent dosing optimization algorithm was derived from these results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We identified four independent risk factors\u2014standard deviation of red blood cell distribution width (RDW-SD), prothrombin time activity (PTA), serum calcium, and Ctac. Notably, the model achieved strong discriminative performance, with AUROCs of 0.802 (95% CI 0.723\u22120.881,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) pre-operatively and 0.824 (95% CI 0.734\u20130.913,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) post-operatively. Using an optimal cutoff of 0.817, the dosing algorithm calculates an individualized maximum safe tacrolimus concentration for each patient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides a pre-operative risk prediction model and a post-operative dosing tool that, used in tandem, can aid in the prevention of PTHU and the protection of renal allograft function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdgth.2026.1887452","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T05:30:49Z","timestamp":1785735049000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A two-phase digital tool to predict and prevent post-transplant hyperuricemia"],"prefix":"10.3389","volume":"8","author":[{"given":"Min","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limian","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Tian","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Shenzhen Technology University","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongqiang","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunni","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yourou","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiyun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"He","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenmei","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qijun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Liver Transplantation, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenping","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Kidney Transplantation, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miaona","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Shenzhen Third People's Hospital","place":["Shenzhen, Guangdong Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"471","DOI":"10.2215\/cjn.05021107","article-title":"Kidney 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