Kidney transplantation
(Med Clin N Am 2016;100:435)
- Refer when GFR <20. Contraindic: active malig, infxn, ischemia, noncompl, subst use
- 5-yr survival: living donor 91%; deceased donor 70–84% (AJKD 2016;23:281). Donors have minor ↑ risk of ESRD (Am J Transplant 2014;14:2434).
- Immunosuppression-Kidney transplantation
- Rejection-Kidney transplantation
- Late renal dysfxn
- ↑ infxn (incl opportunistic such as CMV, JC, BK viruses; CJASN 2012;7:2058) & cancer (PTLD)
- ↑ CVD risk due to HTN (calcineurin inhib, RAS), DM & dyslipidemia (immunosupp meds)