CMV (cytomegalovirus) infection is quite common in the transplant population, and fortuantely the development and utilization of valganciclovir (Valcyte), an oral prodrug of ganciclovir, as a prophylactic agent has dramatically cut down on the number of CMV infections…
There are many diseases which can recur following renal transplant: examples include IgA Nephropathy (which has a very high rate of recurrence on follow biopsy but is rarely clinically relevant in that it does not cause significant allograft…
Did you know that diarrhea increases the absorption of Prograf (tacrolimus, FK506)? Drug levels must be monitored closely in this setting to avoid tacrolimus-induced allograft toxicity. Tacrolimus is even considered a cause of diarrhea by some, though its…
Leflunomide is a drug I’ve seen used with increasing frequency in the renal transplant world. Marketed under the trade name “Arava”, it is an immunomodulatory agent which works by inhibition of the enzyme dihydroorotate dehydrogenase, one of the…
Interesting transplant case: A 35 year old man with a history of acute myelogenous leukemia, status post a bone marrow transplant from his sister eight years ago and now cured, who developed chronic kidney disease as a result…
Rapamycin (sirolimus) is a commonly used immunosupressant deriving from the bacterium Streptomyces hygroscopicus, originally found on Easter Island. It was originally developed as an antifungal agent but later found to have potent immunosuppressive and antiproliferative properties. Although effective,…
The term chronic allograft nephropathy (CAN) has long been used to describe the non-specific injury to kidney transplants that is the most common cause of late (>1 year post-transplant) allograft dysfunction. With the 2007 Banff classification system, however,…
A quick fact about foscarnet, one of the many drugs which can cause drug-induced hypocalcemia. Foscarnet is an antiviral medication, commonly used in the treatment of herpesviruses and CMV infections (e.g., CMV retinitis). The mechanism of its hypocalcemic…
