Which factor is essential to protect the transplanted kidney?

• A. It has little impact on graft survival
• B. It is about weight loss
• C. Careful management of diabetes and hypertension
• D. It negates the need for immunosuppressants

Answer: (C)

Controlling diabetes and hypertension is essential to protect the transplanted kidney because the graft remains vulnerable to vascular and metabolic injury after transplantation. High blood pressure places extra stress on the transplanted kidney, accelerating graft vascular damage and scarring, which can shorten its function. Diabetes, including post-transplant diabetes, leads to microvascular injury and can worsen the effects of other treatments, increasing the risk of graft dysfunction. Together, keeping blood glucose and blood pressure well managed helps preserve graft function and improve long-term survival.

Immunosuppressive therapy is still required to prevent rejection, but it doesn’t replace the need to optimize these metabolic factors. Weight loss and overall health are beneficial, but they aren’t the single essential factor for protecting the graft. And skipping immunosuppressants would expose the graft to rejection, which is not acceptable.