The following is a summary of ‘’Risk Factors for Infection in Patients with a Failed Kidney Allograft on Immunosuppression,” published in the July 2023 issue of Nephrology by Ogawa et al.

Immunosuppressed patients with failing kidney allografts face infection risks, but associations with specific regimens require review. Researchers performed a retrospective study to review the literature on managing failed kidney allografts and associated infectious risks, highlighting infection prevention practices. They explored infection experiences in patients with failed allografts through fifteen identified studies (1995-2022). Infections were predominantly documented as general events, with specific cases including Candida, Mycobacterium tuberculosis, and Aspergillus.  The definition of reduced immunosuppression (IS) varied among studies, ranging from decreased triple drug regimen to monotherapy or unspecified medications. 

They reported that despite efforts to reduce immunosuppression, patients with failed allografts face risks of opportunistic and non-opportunistic infections. Although opportunistic infections resulting from immunosuppression were anticipated,  it was unexpected that the highest infection risk was associated with dialysis complications. Therefore, implementing strategies such as prioritizing arteriovenous (AV) fistula placement over hemodialysis catheters may help mitigate infection risks.

Study concluded that further research is required to investigate infection types, timing, and specific immunosuppression details for managing failed kidney allografts, guiding patient management, and informing infection surveillance and prophylaxis strategies.

Source: frontiersin.org/articles/10.3389/fneph.2023.1149116/abstract