Fahad Aziz

Purpose of Review: Proteinuria is a post-kidney transplant complication associated with adverse patient and graft outcomes. While proteinuria guidelines in non-transplant chronic kidney disease have adapted to emerging evidence, similar guidelines in transplantation ought to as well. Recent Findings: Recent evidence suggests that quantifiable albuminuria, even in patients without detectable proteinuria significantly impacts kidney transplant recipients, increasing odds of graft failure 25-fold, all-cause mortality nearly 5-fold, cardiovascular mortality nearly 7-fold, and malignancy-related mortality more than 8-fold. Such data along with the contemporary paradigm shift in field-changing anti-proteinuric therapeutics have prompted this examination of post-transplant proteinuria. Summary: In this review, we aim to refine current understanding of post-transplant proteinuria as well as highlight key broad strategies beyond rejection applicable to the broader audience of nephrologists involved in the care of kidney transplant recipients.