Key result
Review highlights mitigation strategies and pharmacotherapies for kidney dysfunction following heart transplantation.
This state-of-the-art review highlights the growing burden of kidney dysfunction after heart transplantation and summarizes emerging evidence for nephroprotective therapies like SGLT2 inhibitors in this population.
Kidney dysfunction after heart transplantation (HT) is associated with significant morbidity and mortality. Recipient and perioperative factors may all influence the risk of kidney injury. Furthermore, data suggest that the incidence of kidney dysfunction, both acute and chronic, is increasing after the implementation of the United States’ 2018 allocation system due to increasing use of temporary mechanical circulatory support and changing recipient characteristics. While data are robust regarding nephroprotective therapies such as renin-angiotensin-aldosterone system inhibition and SGLT2 (sodium-glucose cotransporter 2) inhibitors to minimize the progression of chronic kidney disease in patients with heart failure, data in HT recipients are beginning to emerge. This state-of-the-art review will critically examine the existing literature regarding the epidemiology of kidney dysfunction after HT, mitigation strategies for acute kidney injury and chronic kidney disease, including pharmacotherapeutics, the need for kidney transplantation after HT, and practical next steps for the larger HT community.
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DeFilippis et al. (2026) conducted a review in Kidney dysfunction after heart transplantation. Nephroprotective therapies (e.g., RAAS inhibitors, SGLT2 inhibitors) was evaluated. This state-of-the-art review examines the epidemiology, mitigation strategies, and pharmacotherapeutics for acute and chronic kidney dysfunction following heart transplantation.
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