mTOR inhibitor-associated proteinuria in kidney transplant recipients

The use of mammalian target of rapamycin inhibitor (mTOR-I) after kidney transplantation has been associated with a higher incidence of proteinuria compared with calcineurin inhibitors (CNIs). This review will focus on mTOR-I-associated proteinuria in different settings after kidney transplantation: de novo mTOR-I treatment in combination with CNI, de novo mTOR-I-containing and CNI-free treatment, early conversion from a CNI-based regimen to an mTOR-I-based regimen, and late conversion. Some possible mechanisms of mTOR-I-induced proteinuria will also be reviewed.