PCSK9 inhibitors: a promising lipid-lowering strategy for kidney transplant recipients

Recent advancements in transplant techniques and immunosuppressive drugs have improved long-term survival rates and increased the age of transplant recipients. Dyslipidemia has become a major complication, leading to atherosclerotic cardiovascular disease as the primary cause of renal function loss and mortality, surpassing rejection. Although statins are the first-line treatment, many patients face limitations due to drug interactions, side effects, and renal function impacts, resulting in suboptimal lipid control and limited clinical benefits. Thus, there is a clear need for alternative lipid-lowering treatments for kidney transplant recipients. Proprotein convertase subtilisin/kexin type 9 (PCSK9)inhibitors have shown promise in cardiovascular disease management in the general population, but research on their use in kidney transplant patients is limited to case reports and small-scale studies. This article reviews the progress of PCSK9 inhibitors in lipid management for these patients, discussing their mechanisms, metabolism, clinical applications, efficacy, and safety, while providing insights for future research and clinical practice to enhance blood lipid management guidelines and improve the quality of life and survival rates of kidney transplant recipients.