첨부한 자료(유튜브 클립, 참고문헌 등)를 학문적 목적으로만 사용해 주시길 부탁드립니다

Review J Clin Med
. 2022 Oct 17;11(20):6108. doi: 10.3390/jcm11206108.
Challenges in the Management of the Patient with a Failing Kidney Graft: A Narrative Review
Rita Leal 1 2, Clara Pardinhas 1, António Martinho 3, Helena Oliveira Sá 1 2, Arnaldo Figueiredo 2 4, Rui Alves 1 2
Affiliations expand
PMID: 36294429 PMCID: PMC9605319 DOI: 10.3390/jcm11206108
Free PMC article
Abstract
Patients with a failed kidney allograft have steadily increase in recent years and returning to dialysis after graft loss is one of the most difficult transitions for chronic kidney disease patients and their assistant physicians. The management of these patients is complex and encompasses the treatment of chronic kidney disease complications, dialysis restart and access planning, immunosuppression withdrawal, graft nephrectomy, and evaluation for a potential retransplant. In recent years, several groups have focused on the management of the patient with a failing renal graft and expert recommendations are arising. A review of Pubmed, ScienceDirect and the Cochrane Library was performed focusing on the specific care of these patients, from the management of low clearance complications to concerns with a subsequent kidney transplant. Conclusion: There is a growing interest in the failing renal graft and new approaches to improve these patients' outcomes are being defined including specific multidisciplinary programs, individualized immunosuppression withdrawal schemes, and strategies to prevent HLA sensitization and increase retransplant rates.

Keywords: chronic kidney disease; graft intolerance syndrome; immunosuppression; kidney graft failure; withdrawal.