@dragonflylady welcome to Mayo Clinic Connect. I’ve been thinking about you and your brother. I’ve got some experience with autoimmune disease (insulin dependent diabetes), a kidney condition (chronic kidney disease / CKD) and immune suppression. I had a pancreas transplant and am required to have immune suppression for life to prevent rejection. In my situation these conditions are all related. Sometimes the treatment can be complicated and challenging but it is so worth it to be in the best health I can be. I would like to invite your brother to join Mayo Clinic Connect too. There are lots of groups and discussions where he will find useful information: Kidney Conditions, Chronic Kidney Disease, Autoimmune… There is always hope & encouragement here.