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Adverse Effects of Immunosuppression: Nephrotoxicity, Hypertension, and Metabolic Disease

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Pharmacology of Immunosuppression

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 272))

Abstract

The use of Immunosuppression has led to the tremendous improvement in graft survival. However, immunosuppressants have been found to cause a variety of metabolic derangements including but not limited to: insulin resistance and diabetes, hyperlipidemia, hypertension, and weight gain after transplantation. This combination of metabolic risk factors may be associated with increased cardiovascular disease (Grundy et al., Circulation 112(17):2735, 2005). In addition many transplant recipients may have many of these risk factors pre-transplant that are exacerbated by immunosuppression. These facts emphasize the need for rigorous follow-up and management of these risk factors post-transplant.

The most common immune suppressant regimens may include different combinations of these agents: Corticosteroids, Calcineurin inhibitors (CNIs), Mammalian Target of Rapamycin (mTOR) Inhibitors, Antimetabolite.

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Authors and Affiliations

  1. Division of Cardiology, Temple University School of Medicine, Philadelphia, PA, USA

    Jamael Hoosain & Eman Hamad

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  1. Jamael Hoosain
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  2. Eman Hamad
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Correspondence to Eman Hamad .

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Editors and Affiliations

  1. Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, USA

    Howard J. Eisen

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Hoosain, J., Hamad, E. (2021). Adverse Effects of Immunosuppression: Nephrotoxicity, Hypertension, and Metabolic Disease. In: Eisen, H.J. (eds) Pharmacology of Immunosuppression. Handbook of Experimental Pharmacology, vol 272. Springer, Cham. https://doi.org/10.1007/164_2021_547

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