Renal transplant recipients face a heightened risk of tuberculosis due to long-term immunosuppressive therapy. Traditional treatment regimens encounter significant challenges in drug-drug interactions, drug resistance, and adverse reactions. With the continuous development of new antitubercular drugs and precision medicine, new hopes have emerged for optimizing tuberculosis treatment in renal transplant recipients. This review systematically summarizes the epidemiology, pathogenesis, clinical characteristics, diagnosis, and therapeutic advances of tuberculosis in renal transplant recipients, with a special focus on the challenges and latest progress in drug therapy to provide insights for clinical practice.

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