Belal AA, Santos Jr AH, Kazory A, Koratala A. Providing care for kidney transplant recipients: An overview for generalists. World J Nephrol 2025; 14(1): 99555 [DOI: 10.5527/wjn.v14.i1.99555]
Corresponding Author of This Article
Abhilash Koratala, MD, Associate Professor, Department of Nephrology, Medical College of Wisconsin, 8701 W Watertown Plank Road, Room A 7633, Milwaukee, WI 53226, United States. akoratala@mcw.edu
Research Domain of This Article
Management
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Mar 25, 2025; 14(1): 99555 Published online Mar 25, 2025. doi: 10.5527/wjn.v14.i1.99555
Providing care for kidney transplant recipients: An overview for generalists
Amer A Belal, Alfonso H Santos Jr, Amir Kazory, Abhilash Koratala
Amer A Belal, Alfonso H Santos Jr, Amir Kazory, Department of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL 32610, United States
Abhilash Koratala, Department of Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, United States
Author contributions: Belal AA contributed to the writing of the original draft, literature review; Santos Jr AH and Kazory A contributed to the revision; Koratala A contributed to the conception and design of the work; Belal AA and Koratala A contributed to the critical revision, editing; Belal AA, Santos Jr AH, Kazory A, and Koratala A contributed to approval of the final version of the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abhilash Koratala, MD, Associate Professor, Department of Nephrology, Medical College of Wisconsin, 8701 W Watertown Plank Road, Room A 7633, Milwaukee, WI 53226, United States. akoratala@mcw.edu
Received: July 24, 2024 Revised: December 25, 2024 Accepted: January 2, 2025 Published online: March 25, 2025 Processing time: 179 Days and 10 Hours
Abstract
Kidney transplantation is the preferred treatment for patients with advanced chronic kidney disease and end-stage kidney disease, offering superior quality of life and survival compared to dialysis. This manuscript provides an updated overview of post-transplant care, highlighting recent advancements and current practices to assist generalists in managing these patients. It covers key areas such as immunosuppression strategies, drug interactions, and the management of transplant-specific acute kidney injury. The focus includes the use of sodium-glucose cotransporter-2 inhibitors and cell-free DNA monitoring for evaluating allograft health and immune-mediated injury. The manuscript reviews the fundamentals of immunosuppression, including both induction and maintenance therapies, and underscores the importance of monitoring kidney function, as well as addressing hypertension, diabetes, and infections. It also provides recommendations for vaccinations and cancer screening tailored to kidney transplant recipients and emphasizes lifestyle management strategies, such as exercise and sodium intake, to reduce post-transplant complications.
Core Tip: This updated overview serves as a comprehensive guide for generalists involved in post-kidney transplant care. It covers essential aspects such as the management of immunosuppression, drug interactions, and acute kidney injury, as well as the integration of advanced therapies like sodium-glucose cotransporter-2 inhibitors and cell-free DNA monitoring. In addition to lifestyle management and targeted screening recommendations, we provide guidance on managing pregnancy after a successful kidney transplant. We also highlight when it is appropriate to consult subspecialists for further expertise in managing complex cases or complications, ensuring optimal care for transplant recipients.
