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Review

Adverse Drug Events after Kidney Transplantation

by
Lionel Rostaing
1,2,3,*,
Thomas Jouve
1,2,
Florian Terrec
1,
Paolo Malvezzi
1 and
Johan Noble
1
1
Nephrology, Hemodialysis, Apheresis and Kidney Transplantation Department, University Hospital Grenoble, 38043 Grenoble, France
2
Institute for Advanced Biosciences (IAB), INSERM U 1209, CNRS UMR 5309, Université Grenoble Alpes, 38043 Grenoble, France
3
Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
*
Author to whom correspondence should be addressed.
J. Pers. Med. 2023, 13(12), 1706; https://doi.org/10.3390/jpm13121706
Submission received: 12 November 2023 / Revised: 4 December 2023 / Accepted: 9 December 2023 / Published: 14 December 2023
(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)

Abstract

Introduction: Kidney transplantation stands out as the optimal treatment for patients with end-stage kidney disease, provided they meet specific criteria for a secure outcome. With the exception of identical twin donor–recipient pairs, lifelong immunosuppression becomes imperative. Unfortunately, immunosuppressant drugs, particularly calcineurin inhibitors like tacrolimus, bring about adverse effects, including nephrotoxicity, diabetes mellitus, hypertension, infections, malignancy, leukopenia, anemia, thrombocytopenia, mouth ulcers, dyslipidemia, and wound complications. Since achieving tolerance is not feasible, patients are compelled to adhere to lifelong immunosuppressive therapies, often involving calcineurin inhibitors, alongside mycophenolic acid or mTOR inhibitors, with or without steroids. Area covered: Notably, these drugs, especially calcineurin inhibitors, possess narrow therapeutic windows, resulting in numerous drug-related side effects. This review focuses on the prevalent immunosuppressive drug-related side effects encountered in kidney transplant recipients, namely nephrotoxicity, post-transplant diabetes mellitus, leukopenia, anemia, dyslipidemia, mouth ulcers, hypertension, and viral reactivations (cytomegalovirus and BK virus). Additionally, other post-kidney-transplantation drugs such as valganciclovir may also contribute to adverse events such as leukopenia. For each side effect, we propose preventive measures and outline appropriate treatment strategies.
Keywords: kidney transplantation; immunosuppression; adverse drug event; nephrotoxicity; NODAT; anemia; leukopenia; viral reactivation; hypertension; dyslipidemia kidney transplantation; immunosuppression; adverse drug event; nephrotoxicity; NODAT; anemia; leukopenia; viral reactivation; hypertension; dyslipidemia

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MDPI and ACS Style

Rostaing, L.; Jouve, T.; Terrec, F.; Malvezzi, P.; Noble, J. Adverse Drug Events after Kidney Transplantation. J. Pers. Med. 2023, 13, 1706. https://doi.org/10.3390/jpm13121706

AMA Style

Rostaing L, Jouve T, Terrec F, Malvezzi P, Noble J. Adverse Drug Events after Kidney Transplantation. Journal of Personalized Medicine. 2023; 13(12):1706. https://doi.org/10.3390/jpm13121706

Chicago/Turabian Style

Rostaing, Lionel, Thomas Jouve, Florian Terrec, Paolo Malvezzi, and Johan Noble. 2023. "Adverse Drug Events after Kidney Transplantation" Journal of Personalized Medicine 13, no. 12: 1706. https://doi.org/10.3390/jpm13121706

APA Style

Rostaing, L., Jouve, T., Terrec, F., Malvezzi, P., & Noble, J. (2023). Adverse Drug Events after Kidney Transplantation. Journal of Personalized Medicine, 13(12), 1706. https://doi.org/10.3390/jpm13121706

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