Overlooked challenges after kidney transplantation: non-immunologic complications from a single-center experience

Aims: This study investigates non-immunologic complications in kidney transplant recipients, focusing on their incidence and risk factors. Methods: A retrospective observational analysis was conducted on 416 adult patients who underwent kidney transplantation at a tertiary care hospital between 2002 and 2016. Demographic, clinical, and laboratory data, as well as post-transplant complications, were extracted from medical records. Statistical analysis was performed to evaluate risk factors associated with new-onset diabetes mellitus (NODAT), hypertension, dyslipidemia, hyperuricemia, and avascular necrosis. Results: The most common complication was dyslipidemia (70.2%), followed by NODAT (24.8%), hypertension (19.7%), hyperuricemia (10.6%), and avascular necrosis (4.8%). Advanced age, higher BMI, elevated CRP, male gender, and CMV positivity were significantly associated with NODAT. Hypertension was linked to calcineurin inhibitor use, while dyslipidemia correlated with higher BMI and cyclosporine therapy. Hyperuricemia was significantly associated with lower GFR and male gender. Avascular necrosis was predominantly observed in glucocorticoid-treated patients. Effective management of these complications is critical to improving patient outcomes. Conclusion: Metabolic complications are prevalent and have a significant impact on post-transplant survival. Regular follow-up and individualized management strategies are essential to address these risks and enhance long-term outcomes for kidney transplant recipients. Further multicenter prospective studies are recommended to validate these findings.