{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T01:51:45Z","timestamp":1775872305148,"version":"3.50.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Calcineurin inhibitor (CNI) pain syndrome is a rare but debilitating adverse effect of CNIs when used in kidney transplant recipients. The pain affects lower limbs and it is usually bilateral and symmetrical. All other causes of foot pain should be excluded before diagnosis. Treatment is not always successful and options are limited as the mainstay is either CNI withdrawal or dose reduction. The available treatments can compromise graft function and lead to reduced graft survival. Herein, we report a case of CNI pain syndrome in a kidney transplant recipient in which belatacept was used successfully. There was complete pain relief and regain of function in affected lower limb. The bone marrow edema also significantly improved on magnetic resonance imaging. Normal kidney functions were maintained on follow-up.<\/jats:p>","DOI":"10.1093\/ckj\/sfag027","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T12:50:31Z","timestamp":1770209431000},"source":"Crossref","is-referenced-by-count":1,"title":["Belatacept for calcineurin inhibitor-induced pain syndrome in a kidney transplant recipient"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3321-2117","authenticated-orcid":false,"given":"Ehab","family":"Hammad","sequence":"first","affiliation":[{"name":"Department of Kidney and Pancreas Transplant, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Centre , Riyadh ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tariq","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Kidney and Pancreas Transplant, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Centre , Riyadh ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amr","family":"Shabana","sequence":"additional","affiliation":[{"name":"Department of Radiology, King Faisal Specialist Hospital and Research Center , Riyadh ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dieter","family":"Broering","sequence":"additional","affiliation":[{"name":"Organ Transplant Center, King Faisal Specialist Hospital and Research Center , Riyadh ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rehab","family":"Nasr","sequence":"additional","affiliation":[{"name":"Department of Kidney and Pancreas Transplant, Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Centre , Riyadh ,","place":["Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"2026031808521072800_bib1","doi-asserted-by":"publisher","first-page":"1876","DOI":"10.1111\/j.1600-6143.2009.02726.x","article-title":"Calcineurin inhibitor minimization in the Symphony study: observational results 3 years after transplantation","volume":"9","author":"Ekberg","year":"2009","journal-title":"Am J Transplant"},{"key":"2026031808521072800_bib2","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1111\/j.1432-2277.2008.00668.x","article-title":"Post-transplant distal limb syndrome: clinical diagnosis and long-term outcome in 37 renal transplant recipients","volume":"21","author":"Tillmann","year":"2008","journal-title":"Transpl Int"},{"key":"2026031808521072800_bib3","first-page":"63","article-title":"Calcineurin inhibitor-induced pain syndrome after kidney transplantation-a rare but disabling condition","volume":"4","author":"Breitenstein","year":"2011","journal-title":"NDT Plus"},{"key":"2026031808521072800_bib4","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1111\/j.1432-2277.2001.tb00004.x","article-title":"Calcineurin- inhibitor induced pain syndrome( CIPS): a severe disabling complication after organ transplantation","volume":"14","author":"Grotz","year":"2001","journal-title":"Transpl Int"},{"key":"2026031808521072800_bib5","first-page":"753","article-title":"[Painful polyartic- 205 ular syndrome probably induced by cyclosporin in three patients with a kidney transplant and one with a heart transplant]","volume":"56","author":"Bouteiller","year":"1989","journal-title":"Rev Rhum Mal Osteoartic"},{"key":"2026031808521072800_bib6","doi-asserted-by":"publisher","first-page":"2510","DOI":"10.1016\/j.transproceed.2012.07.138","article-title":"Pain syndrome induced by calcineurin inhibitor and resolved by conversion to 210 sirolimus in a child after kidney transplantation: a case report","volume":"44","author":"Prates","year":"2012","journal-title":"Transplant Proc"},{"key":"2026031808521072800_bib7","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1177\/1526924816654832","article-title":"Pregabalin: a new adjunct in calcineurin inhibitor pain syndrome treatment","volume":"26","author":"Ta\u015fo\u011flu","year":"2016","journal-title":"Prog Transplant"},{"key":"2026031808521072800_bib8","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1111\/j.1600-6143.2010.03016.x","article-title":"A phase III study of belatacept versus cyclosporine in kidney transplants from extended criteria donors( BENEFIT-EXT study)","volume":"10","author":"Durrbach","year":"2010","journal-title":"Am J Transplant"},{"key":"2026031808521072800_bib9","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1111\/j.1600-6143.2009.03005.x","article-title":"A phase III study of belatacept-based immunosuppression regimens versus cyclosporine in renal transplant recipients( BENEFIT study)","volume":"10","author":"Vincenti","year":"2010","journal-title":"Am J Transplant"},{"key":"2026031808521072800_bib10","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1111\/ajt.12712","article-title":"Renal transplantation using belatacept without maintenance steroids or calcineurin inhibitors","volume":"14","author":"Kirk","year":"2014","journal-title":"Am J Transplant"},{"key":"2026031808521072800_bib11","doi-asserted-by":"publisher","first-page":"125","DOI":"10.4103\/ijot.ijot_19_18","article-title":"Diagnosis and treatment of calcineurin inhibitor- induced pain syndrome in chronic kidney disease stage 5 transplantation","volume":"12","author":"Amiri","year":"2018","journal-title":"Indian J Transpl"},{"key":"2026031808521072800_bib12","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1111\/tri.12330","article-title":"Conversion to mammalian target of rapamycin inhibitors increases risk of de novo donor-specific antibodies","volume":"27","author":"Croze","year":"2014","journal-title":"Transpl Int"},{"key":"2026031808521072800_bib13","doi-asserted-by":"publisher","first-page":"326","DOI":"10.2215\/CJN.03751106","article-title":"High sirolimus levels may induce focal segmental glomerulosclerosis de novo","volume":"2","author":"Letavernier","year":"2007","journal-title":"Clin J Am Soc Nephrol"},{"key":"2026031808521072800_bib14","doi-asserted-by":"publisher","first-page":"771","DOI":"10.1080\/02841850802161023","article-title":"Bone marrow edema: pathophysiology, differential diagnosis, and imaging","volume":"49","author":"Starr","year":"2008","journal-title":"Acta Radiol"},{"key":"2026031808521072800_bib15","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1097\/AJP.0b013e31823a67f1","article-title":"Calcineurin-inhibitor pain syndrome","volume":"28","author":"Prommer","year":"2012","journal-title":"Clin J Pain"},{"key":"2026031808521072800_bib16","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1056\/NEJMoa1506027","article-title":"Belatacept and long-term outcomes in kidney transplantation","volume":"374","author":"Vincenti","year":"2016","journal-title":"N Engl J Med"}],"container-title":["Clinical Kidney Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ckj\/advance-article-pdf\/doi\/10.1093\/ckj\/sfag027\/66788442\/sfag027.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/19\/3\/sfag027\/66788442\/sfag027.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/19\/3\/sfag027\/66788442\/sfag027.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T12:55:57Z","timestamp":1773838557000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ckj\/article\/doi\/10.1093\/ckj\/sfag027\/8465368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":16,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ckj\/sfag027","relation":{},"ISSN":["2048-8505","2048-8513"],"issn-type":[{"value":"2048-8505","type":"print"},{"value":"2048-8513","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,3]]},"published":{"date-parts":[[2026,2,5]]},"article-number":"sfag027"}}