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Abstract
Non-traditional risk factors are higher in patients with CKD and include raised calcium and phosphate, hyperhomocysteinemia, inflammation and oxidative stress, leading to accelerated atherosclerosis and endothelial dysfunction. Anaemia and hyperparathyroidism have been attributed to neurocognitive impairment as a result of reduced delivery of oxygen, and parathyroid hormone (PTH) interfering with neurotransmission in the CNS as a result of elevated calcium levels in the brain, respectively. An atypical haemolytic uraemic syndrome and the clinical spectrum of thrombotic thrombocytopenic purpura (TTP) as well as their pathological manifestations are mostly limited to the kidney in calcineurin inhibitor (CnI) induced TMA in kidney transplant recipients (which is a rare but well-recognised complication seen only in upto 1% of the transplant population on CnI).