What question did this study set out to answer?

To compile evidence on pharmacological therapies improving heart-kidney outcomes in kidney transplant recipients.

July 26, 2026Clinical Journal of the American Society of Nephrology

Evidence-Based Cardiovascular–Kidney–Metabolic Therapies in Kidney Transplant Recipients

Q: What is the clinical evidence from this study?

Study design: Review. Population: Cardiovascular-kidney-metabolic syndrome in kidney transplant recipients. Intervention: Cardiovascular-kidney-metabolic therapies (RAAS inhibitors, statins, SGLT2 inhibitors, GLP-1 receptor agonists).

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Key result

RAASi, statins, SGLT2i, and GLP-1RA emerge as four proposed pillars for heart-kidney outcomes in transplant recipients.

Why the study?

New pharmacological agents have emerged to improve combined heart-kidney outcomes in cardiovascular-kidney-metabolic syndrome, motivating a review of current evidence for their use in kidney transplant recipients.

Population

Kidney transplant recipients

Design

Review

Authors

GSGautam R. ShroffGeneral Cardiology XCXingxing S. ChengPalo Alto University AGAra GharabagiSaint Louis University Hospital

Discussion

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Implication

Supports RAAS inhibitor backbone in kidney transplant recipients; extends evidence on novel agents but leaves practice change open.

Key Points

To compile evidence on pharmacological therapies improving heart-kidney outcomes in kidney transplant recipients.
Review of clinical trials, systematic reviews, and meta-analyses concerning therapeutic agents.
Focus on key pharmacological classes and their interactions in kidney transplant context.
Assessment of treatment implications for specific comorbidities like coronary heart disease.
Renin-angiotensin-aldosterone inhibitors remain the backbone therapy with multiple indications.
Sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists show promise for certain comorbidities.
Evidence for mineralocorticoid receptor antagonists and angiotensin receptor-neprilysin inhibitors is still emerging.

Structured PICO

Population

Kidney transplant recipients

Intervention

Cardiovascular-kidney-metabolic therapies (renin-angiotensin-aldosterone system inhibitors, statins, sodium-glucose cotransporter-2 inhibitors, and glucagon-like peptide-1 receptor agonists)

This review highlights RAAS inhibitors, statins, SGLT2 inhibitors, and GLP-1 receptor agonists as the four key pillars of pharmacological management for improving heart-kidney outcomes in kidney transplant recipients.

Limitations

Evidence for mineralocorticoid receptor antagonists and angiotensin receptor-neprilysin inhibitors is not adequate to support routine clinical use.
There remains a critical need for randomized trials in this vulnerable population focused on improvement in combined heart-kidney outcomes.
Critical need for randomized trials in this vulnerable population focused on improvement in combined heart-kidney outcomes

Cite This Study

Shroff et al. (2026) conducted a review in Cardiovascular-kidney-metabolic syndrome in kidney transplant recipients. Cardiovascular-kidney-metabolic therapies (RAAS inhibitors, statins, SGLT2 inhibitors, GLP-1 receptor agonists) was evaluated. This review proposes that RAAS inhibitors, statins, SGLT2 inhibitors, and GLP-1 receptor agonists constitute the four key pillars for improving heart-kidney outcomes in kidney transplant recipients.

synapsesocial.com/papers/6a65a7e0d3aea3239cd78797 https://doi.org/10.2215/cjn.0000001195

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Evidence-Based Cardiovascular–Kidney–Metabolic Therapies in Kidney Transplant Recipients

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Evidence-Based Cardiovascular–Kidney–Metabolic Therapies in Kidney Transplant Recipients

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

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