Complementary and integrative medicine in kidney transplantation

Complementary and integrative medicine (CIM) use is widely prevalent in kidney transplant recipients but studies of efficacy or potential harm are sparse. This review examines prevalence of use of CIM and discusses potential beneficial and harmful aspects of CIM in renal transplant recipients.

The prevalence of CIM use in kidney transplant patients varies from 12 to 45%. There is a knowledge gap regarding CIM modalities among healthcare professionals that may contribute to reluctance to discuss CIM use with patients. Patients often do not spontaneously disclose its use, and those that use it may be more likely to be nonadherent to allopathic therapies. Herbal supplements may be nephrotoxic or interact with pharmaceutical agents, including calcineurin inhibitors. More data are needed to assess the potential benefits of other modalities of CIM, including yoga, Tai Chi or meditation, as these modalities have been beneficial for people with diabetes or hypertension, both of which are common in the posttransplant period.

Despite a high prevalence of CIM use in kidney transplant recipients, data are limited regarding risks and benefits. Education of healthcare providers who care for kidney transplant recipients should be encouraged. Intervention studies should be designed to investigate the CIM modalities, including yoga, meditation and Tai Chi that have been shown to be beneficial in other chronic diseases.