Journal of the American Society of Nephrology
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J Am Soc Nephrol 18: 3031-3041, 2007
© 2007 American Society of Nephrology
doi: 10.1681/ASN.2007040394
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Brief Review

Chronic Kidney Disease after Nonrenal Solid-Organ Transplantation

Roy D. Bloom and Peter P. Reese

Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania

Correspondence: Dr. Roy D. Bloom, Department of Medicine, Renal-Electrolyte and Hypertension Division, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104. Phone: 215-662-2638; Fax: 215-615-0349; E-mail: rdbloom{at}mail.med.upenn.edu

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.




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