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World J Transplant. Sep 18, 2026; 16(3): 124182
Published online Sep 18, 2026. doi: 10.5500/wjt.124182
Published online Sep 18, 2026. doi: 10.5500/wjt.124182
Reply: Chronic kidney disease after liver transplantation: Accurate measurement, early acute kidney injury, and renal-protective strategies
Pranjal Kashiv, Department of Nephrology, All India Institute of Medical Sciences, Nagpur 441108, Mahārāshtra, India
Khushboo Saxena, Nephrology, IKDRC, Ahmedabad 380016, Gujarāt, India
Manish Ramesh Balwani, Department of Nephrology, Saraswati Kidney Care Center, Nagpur 440015, Maharashtra, India
Vivek B Kute, Department of Treasury, Indian Society of Organ Transplantation (ISOT), Nagpur 440015, Maharashtra, India
Author contributions: Kashiv P was responsible for study design, literature review, data curation, interpretation of evidence, drafting of the manuscript, and coordination of all stages of manuscript preparation and revision; Balwani MR contributed to the conception and design of the study, provided senior oversight, supervised the work, and critically revised the manuscript for important intellectual content; Saxena K contributed to data curation, literature review, and critical review of the manuscript; Kute VB contributed to conception, senior supervision, overall project administration, and critical revision of the manuscript for important intellectual content.
AI contribution statement: No artificial intelligence tools were used in the generation of the manuscript. ChatGPT was used solely for minor grammatical corrections and language refinement, without influencing the scientific content, interpretation, or conclusions of the work.
Conflict-of-interest statement: On behalf of all the authors, the corresponding author confirms that there are no conflicts of interest related to this manuscript.
Corresponding author: Vivek B Kute, MD, Department of Treasury, Indian Society of Organ Transplantation (ISOT), Saraswati Kidney Care Center, 13, New Sneh Nagar, Nagpur 440015, Maharashtra, India. drvivekkute@rediffmail.com
Received: July 3, 2026
Revised: July 13, 2026
Accepted: July 15, 2026
Published online: September 18, 2026
Processing time: 83 Days and 12.9 Hours
Revised: July 13, 2026
Accepted: July 15, 2026
Published online: September 18, 2026
Processing time: 83 Days and 12.9 Hours
Core Tip
Core Tip: Sessa et al recast chronic kidney disease after liver transplantation as a preventable threat to survival. We press their case further. The creatinine-based estimates that underpin every reported risk factor, the female sex signal included, should give way to cystatin C, measured glomerular filtration and the albuminuria axis. Surveillance should follow intrapatient tacrolimus variability rather than isolated troughs that fail to predict chronic disease. And nephroprotective pharmacotherapy, sodium glucose cotransporter 2 inhibitors foremost among them, deserves formal trial in this population rather than continued neglect.