Infectious Disease Prophylaxis During and After Immunosuppressive Therapy

Lorne Schweitzer; Benjamin A Miko; Marcus R Pereira

doi:10.1016/j.ekir.2024.04.043

Infectious Disease Prophylaxis During and After Immunosuppressive Therapy

Kidney Int Rep. 2024 Apr 25;9(8):2337-2352. doi: 10.1016/j.ekir.2024.04.043. eCollection 2024 Aug.

Authors

Lorne Schweitzer^{1

2

3}, Benjamin A Miko^{1

2}, Marcus R Pereira^{1

2}

Affiliations

¹ Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
² Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.
³ Columbia Center for Translational Immunology, Columbia University Irving Medical Center, New York, New York, USA.

Abstract

Immune-mediated renal diseases are a diverse group of disorders caused by antibody, complement, or cell-mediated autosensitization. Although these diseases predispose to infection on their own, a growing array of traditional and newer, more targeted immunosuppressant medications are used to treat these diseases. By understanding their mechanisms of action and the infections associated with suppression of each arm of the immune system, nephrologists can better anticipate these risks and effectively prevent and recognize opportunistic infections. Focusing specifically on nonkidney transplant recipients, this review discusses the infections that can be associated with each of the commonly used immunosuppressants by nephrologists and suggest interventions to prevent infectious complications in patients with immune-mediated renal disease.

Keywords: immunosuppressive therapy; infection prophylaxis; infection screening; opportunistic infections; targeted therapies; vaccination.

Publication types

Review