Chronic kidney disease after nonrenal solid-organ transplantation.
Chronic kidney disease (CKD) is a common complication after nonrenal solid-organ transplantation. The risk for CKD is influenced by many factors, some of which have a direct impact on how such patients are treated in the pre-, peri-, and posttransplantation settings. This review describes hazards for acute and chronic kidney injury, with particular emphasis on calcineurin inhibitor-mediated nephrotoxicity. Rather than a detailed description of management issues that are common to the general CKD population, highlighted are aspects that are more specific to nonrenal solid-organ transplant recipients with a focus on liver, heart, and lung recipients. Strategies to minimize nephrotoxic insults and retard progressive renal injury are discussed, as are issues that are pertinent to dialysis and transplantation. Finally, future approaches to prevent and treat CKD without compromising function of the transplanted organ are addressed.
Department of Medicine, Renal-Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. rdbloom@mail.med.upenn.edu
Roy D
RD
Bloom
Peter P
PP
Reese
D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D065095:Calcineurin Inhibitors; D002908:Chronic Disease; D015897:Comorbidity; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000187:drug effects / Q000293:injuries / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology* / Q000628:therapy; D016377:Organ Transplantation / Q000379:methods*; D011120:Polyomavirus / Q000378:metabolism; D012307:Risk Factors; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents