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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
07:13

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

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

Gautam R Shroff1, Xingxing Cheng2, Ara Gharabagi3

  • 1Division of Cardiology, Department of Medicine, Hennepin Healthcare; and University of Minnesota Medical School, Minneapolis, MN.

Clinical Journal of the American Society of Nephrology : CJASN
|July 29, 2026
PubMed

Insights

New heart-kidney medications show promise for kidney transplant patients with cardiovascular-kidney-metabolic syndrome. Renin-angiotensin-aldosterone system inhibitors and statins are key, with emerging data for SGLT2 inhibitors and GLP-1 RAs.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Cardiovascular-kidney-metabolic (CKM) syndrome impacts kidney transplant recipients (KTRs).
  • Novel pharmacological agents are being developed to improve combined heart-kidney outcomes in CKM syndrome.
  • Evidence for these agents in KTRs is evolving.

Purpose of the Study:

  • To review current evidence on novel pharmacological agents for KTRs with CKM syndrome.
  • To identify key drug classes for improving heart-kidney outcomes in KTRs.
  • To discuss drug interactions, tolerability, and specific cardiovascular conditions in KTRs.

Main Methods:

  • Systematic review of pivotal clinical trials and meta-analyses.
  • Analysis of evidence for renin-angiotensin-aldosterone system inhibitors, SGLT2 inhibitors, GLP-1 RAs, MRAs, ARNIs, and statins.
  • Consideration of drug interactions with immunosuppressants and tolerability.

Main Results:

  • Renin-angiotensin-aldosterone system inhibitors remain foundational.
  • Sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists show support for use in KTRs with comorbidities.
  • Evidence for mineralocorticoid receptor antagonists and angiotensin receptor-neprilysin inhibitors is insufficient for routine use.
  • Statins demonstrate impact on the post-transplant metabolic milieu.

Conclusions:

  • Four key pillars for improving heart-kidney outcomes in KTRs: RAAS inhibitors, statins, SGLT2 inhibitors, and GLP-1 RAs.
  • Practical considerations include drug interactions and tolerability.
  • Further randomized trials are needed to confirm benefits in this vulnerable population.

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