Abstract

Renal transplantation is the modality of choice for renal replacement therapy in patients with end-stage renal disease. Following induction immunosuppression, most maintenance immunosuppressive regimens include a calcineurin inhibitor. While this class of immunosuppressive therapy is highly effective it has a toxic effect on the renal allograft termed calcineurin inhibitor toxicity which can contribute to graft loss over time. Thus, their minimization, withdrawal or avoidance is of interest to transplant clinicians as well to renal transplant recipients. This mini review takes an in-depth review and analysis of all published data in this field.

Keywords: Calcineurin inhibitor; Renal transplant; Kidney transplant

Abbreviations: CNI: Calcineurin Inhibitors; SRL: Sirolimus; ESRD: End Stage Renal Disease; CAN: Chronic allograft nephropathy; DFG: Death with functioning graft; mTORi: Mammalian Target of Rapamycin Inhibitors; CsA: Cyclosporine; TAC: Tacrolimus; MMF: Mycophenolate Mofetil; AZA: Azathioprine; BPAR: Biopsy Proven Acute Rejection