Lipid Management in CKD — ESENeph MCQ
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Correct answer: E — Individualise immunosuppression reduction with transplant-oncology input
The best answer is “Individualise immunosuppression reduction with transplant-oncology input”. KDIGO advises considering immunosuppression reduction in transplant recipients with cancer, balancing tumour control against rejection and sensitisation. The plan depends on cancer type, stage and available therapy. “Stop every immunosuppressant immediately without assessing rejection risk” is less appropriate because abrupt withdrawal can precipitate graft rejection and must be individualised “Increase immunosuppression to improve tumour immune tolerance” is less appropriate because greater immunosuppression may promote malignant progression “Leave the regimen unchanged in every cancer type” is less appropriate because cancer type, stage, treatment, graft risk and drug interactions influence adjustment “Replace cancer treatment with graft nephrectomy” is less appropriate because graft removal is not a general treatment for an unrelated malignancy
Reference: KDIGO kidney transplant recipient guideline: https://kdigo.org/wp-content/uploads/2022/09/KDIGO-2009-Transplant-Recipient-Guideline-English.pdf