1. Paraneoplastic Syndrome After Kidney Transplantation: Frequency, Risk Factors, Differences to Paraneoplastic Occurrence of Glomerulonephritis in the Native Kidney, and Implications on Long-Term Kidney Graft Function.
- Author
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Zakrocka I, Nair G, Soler MJ, Jhaveri KD, and Kronbichler A
- Subjects
- Humans, Risk Factors, Immunosuppressive Agents adverse effects, Immunosuppressive Agents therapeutic use, Postoperative Complications etiology, Postoperative Complications epidemiology, Graft Survival, Kidney Transplantation adverse effects, Paraneoplastic Syndromes etiology, Glomerulonephritis etiology
- Abstract
Posttransplant malignancies are an important complication of solid organ transplantation. Kidney transplant recipients are at particularly high risk of cancer development. The most relevant risk factors of carcinogenesis are the use of immunosuppressive agents and oncogenic viral infections. Additionally, immune dysregulation caused by these factors may predispose to various types of organ damage. Paraneoplastic glomerular diseases are one of the most interesting and understudied cancer manifestations. The appropriate diagnosis of paraneoplastic glomerular damage can be challenging in kidney transplant recipients, due to factors inherent to concomitant medication and common comorbidities. Recent advances in the field of molecular and clinical nephrology led to a significant improvement in our understanding of glomerular diseases and their more targeted treatment. On the other hand, introduction of novel anticancer drugs tremendously increased patients' survival, at the cost of kidney-related side effects. Our review aims to provide insights into diagnosis and treatment of paraneoplastic glomerular diseases, with a special attention to kidney transplant recipients., Competing Interests: IZ received grant support by Chiesi, Sanofi and Takeda and received consultancy fees from Astra Zeneca, Boehringer Ingelheim, Chiesi, Sandoz and Sanofi. AK received grant support by CSL Vifor and Otsuka, and received consultancy fees from CSL Vifor, Otsuka, Walden Biosciences, Catalyst Biosciences, AstraZeneca, Glaxo Smith Kline, Roche and Delta 4. He is Editorial Board member of Nephrology Dialysis Transplantation, Glomerular Diseases and Current Rheumatology Reports. KJ reports consultancy agreements with PMV pharmaceuticals, ChemoCentryx, GlaxoSmithKline, George Clinicals and Travere Therapeutics; reports honoraria from the American Society of Nephrology and Lexicomp; is a paid contributor to UpToDate.com and is section editor for onconephrology for Nephrology Dialysis Transplantation; serves on the editorial boards of American Journal of Kidney Diseases, CJASN, Clinical Kidney Journal, Frontiers in Nephrology, Journal of Onco-Nephrology, and Kidney International; serves as the Editor-in-Chief of ASN Kidney News. MS reports personal fees and consultancy agreements with NovoNordisk, Jansen, Mundipharma, AstraZeneca, Esteve, Fresenius, Ingelheim Lilly, Vifor, ICU, Pfizer, Bayer, Travere Therapeutics, GE Healthcare and grants and personal fees from Boehringer Ingelheim. She is Editorial Board member of Clinical Kidney Journal, vice-president of the Spanish Society of Nephrology and Co-Chair of the Western Europe Regional Board of the International Society of Nephrology. The remaining author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Zakrocka, Nair, Soler, Jhaveri and Kronbichler.)
- Published
- 2024
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