Immunosuppression-related neurological disorders in kidney transplantation

Irene Faravelli, Daniele Velardo, Manuel Alfredo Podestà, Claudio Ponticelli

Research output: Contribution to journalReview articlepeer-review

Abstract

A large number of neurological disorders can affect renal transplant recipients, potentially leading to disabling or life-threatening complications. Prevention, early diagnosis and appropriate management of these conditions are critical to avoid irreversible lesions. A pivotal role in the pathogenesis of common post-transplant neurological disorders is played by immunosuppressive therapy. The most frequently administered regimen consists of triple immunosuppression, which comprises a calcineurin inhibitor (CNI), a purine synthesis inhibitor and glucocorticoids. Some of these immunosuppressive drugs may lead to neurological signs and symptoms through direct neurotoxic effects, and all of them may be responsible for the development of tumors or opportunistic infections. In this review, after a brief summary of neurotoxic pathogenetic mechanisms encompassing recent advances in the field, we focus on the clinical presentation of more common and severe immunosuppression-related neurological complications, classifying them by characteristics of urgency and anatomic site. Our goal is to provide a general framework that addresses such clinical issues with a multidisciplinary approach, as these conditions require.

Original languageEnglish
Pages (from-to)539-555
Number of pages17
JournalJournal of Nephrology
Volume34
Issue number2
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Immunosuppressive drugs
  • Nervous system
  • Neurological disorders
  • Renal transplantation

ASJC Scopus subject areas

  • Nephrology

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