Renal conditions

Vulnerability

references

Vasculitis, SLE, membranous nephropathy, minimal change disease, IgA nephropathy, FSGS, anti-GBM disease (Goodpasture’s disease)

On immunosuppressant treatment:

Ciclosporin

Leflunomide

Methotrexate

MMF,

Sirolimus

Tacrolimus

Cyclophosphamide only

currently on CYCLOPS/Euro Lupus regimens

Cytotoxics

On biologics/monoclonals/anti-TNF drugs within the last six months including the following (and variants):

Abatacept

Adalimumab

Anakinra

Belimumab

Certolizumab

Etanercept

Golimumab

Infliximab

Ixekizumab

Rituximab

Seukinumab

Tociluzimab

Ustekinumab

Steroid dose (Prednisolone equivalent) ≥ 20mg daily or 35mg/m² bsa/day for more than 4 weeks in the last 6 months

Steroid dose (Prednisolone equivalent) > 5mg daily or 0.25mg/kg/day  for more than 4 weeks plus at least one other immunosuppressant in the last 6 months

Current nephrotic range proteinuria or history of frequently relapsing nephrotic syndrome

overall cumulative burden of immunosuppression is high over a number of years (repeated courses of Cyclophosphamide/biologics/high dose corticosteroids) but in current stable maintenance phase

Add further 6 years (total 12  years) for immunosuppressant medication

currently stable on maintenance treatment

Autoimmune disease affecting cardiovascular or respiratory system such as lung fibrosis

Non-autoimmune co-morbidity of respiratory or cardiovascular system, hypertension or diabetes mellitus

CKD stage 3 or higher

Previous adverse infections complications of immunosuppression e.g. recurrent CMV or chest infections

Patients with one kidney with normal renal function