Thinking Outside the Box: Novel Kidney Protective Strategies in Kidney Transplantation

Hassan N. Ibrahim, Dina N. Murad, Greg A. Knoll

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Despite the reduction in the incidence of acute rejection, a major risk factor for graft loss, there has been only modest improvement in long-term graft survival. Most cases of kidney graft loss have an identifiable cause that is not idiopathic fibrosis/atrophy or calcineurin inhibitor nephrotoxicity. Distinct immunologic and nonimmunologic factors conspire to lead to a common pathway of allograft fibrosis. It remains plausible that mitigating nonimmunologic damage using strategies proven effective in native kidney disease may yield benefit in kidney transplantation. In this review, we will focus on nonimmunologic aspects of kidney transplant care that may prove to be valuable adjuncts to a well-managed immunosuppression regimen. Topics to be addressed include the roles of hypertension and agents used to treat it, lipid lowering, sodium and water intake, elevated uric acid, metabolic acidosis, and the use of sodium-glucose cotransporter 2 inhibitors on long-term kidney transplant health.

Original languageEnglish (US)
Pages (from-to)1890-1897
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume16
Issue number12
DOIs
StatePublished - Dec 2021

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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