Can a cancer drug protect new kidneys from scarring?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Provision of signed and dated informed consent form * Stated willingness to comply with all study procedures and availability for the duration of the study * Receiving a first or second kidney, except those whose first kidney transplant was lost during year 1 due to rejection or recurrent disease * Male or female, aged ≥18 to ≤75 * Women of child bearing potential who have a negative serum pregnancy test prior to treatment * Women of child bearing potential (including perimenopausal women who have had a menstrual period within the previous 1 year) who agree to use 2 forms of effective birth control regimen (at least one of which is a barrier method) throughout the study period and for 6 weeks following the end of the study or the last dose of mycophenolic acid, whichever comes first. * Sexually active male patients who agree to use effective contraception during treatment of the male patient and for at least 90 days after cessation of treatment with mycophenolic acid. * Panel of reactive antibodies (PRA) \<80% based on the most recent PRA results that are closest to the date of transplant * Able to take oral medication * Agreement to adhere to Lifestyle Considerations throughout study duration (refraining from consumption of grapefruit or grapefruit juice; stopping anticoagulation therapy one week prior through one week post-kidney biopsy procedure; agree to follow FDA guidelines regarding contraception while using mycophenolic acid) Exclusion Criteria: * Transplantation of any organ other than kidney * Living donor kidney recipients having a 6-antigen match with their donor or a 0-antigen mismatch * Planned use of non-calcineurin inhibitor immunosuppression maintenance therapy (eg, belatacept) * Patients with primary focal segmental glomerulosclerosis * Recipients of en-bloc kidneys * Patients who have received or are expected to receive alemtuzumab * Presence of any donor-specific antibody observed during the current or historical crossmatch assessment * Presence of primary (or familial) dyslipidemia * Presence of an increased QTc interval \> 480 ms on screening ECG, a history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias, or uncompensated heart failure. * Patients with a history of CABG, cardiac stent placement, or MI within 1 year prior to enrollment * Patients taking high intensity statin therapy (ie, atorvastatin 40 or 80mg, rosuvastatin 20-40mg) * Diagnosed with severe liver disease, including abnormal liver enzymes greater than 3 times the upper limit of normal or total bilirubin greater than 1.5 times the upper limit of normal. * Diagnosed with any past or present malignancies except squamous or basal cell carcinoma of the skin excised prior to randomization. * Diagnosed with active acute or chronic infection, or febrile illness, including absolute neutrophil count less than 1.5 K/µL that, in the Principal Investigator's opinion, would impact the patient's safety or any assessments of this study * Diagnosed with a genetic disease that leads to excessive bleeding (eg, hemophilia A or factor VIII deficiency, hemophilia B or factor IX deficiency, and von Willebrand disease), genetic or acquired disease that leads to excessive clotting (eg, anti-phospholipid syndrome, factor V Leiden thrombophilia, factor II mutation), or a medical condition requiring uninterrupted long-term systemic anticoagulation after transplantation, which would interfere with obtaining biopsies. * Patient with platelet count less than 50 K/µL. * Ever diagnosed with Post-Transplant Lymphoproliferative Disorder (PTLD) if a previous kidney transplant was received * Use of any investigational drug during the 4 weeks prior to enrolling in this study * Women of child bearing potential who are breastfeeding * Women of childbearing potential not practicing reliable methods of contraception. Reliable methods for contraception include surgical sterilization (hysterectomy, bilateral tubal ligation), double-barrier method (such as condom and diaphragm). To be considered as post-menopausal and not of childbearing potential, female participants must have experienced 12 consecutive months of amenorrhea. * Men who are sexually active but do not practice reliable birth control. * Known allergic reactions to components of REZUROCK®, specifically belumosudil mesylate, microcrystalline cellulose, hypromellose, croscarmellose sodium, colloidal silicon dioxide, magnesium stearate, polyvinyl alcohol, polyethylene glycol, talc, titanium dioxide or yellow iron oxide. * Any participant whose surgeon expects they will not perform a baseline biopsy pre- or post-reperfusion of the transplanted organ * Presence of any medical or psychosocial condition, which the investigator believes, would hinder adherence to the study requirements