Caring for patients after kidney transplantation OP is to educate the patient, select optimal and individualized Immunosuppressive treatment, prevent complications, detect them early, and treat them when they occur.
Immunosuppressive therapy is intended to prevent and treat transplant rejection. The patient must take these medications every day, otherwise, he may lose the transplant. Patients usually take 2 or 3 different drugs. Their doses are higher for the first 3 to 6 months and maybe gradually lowered later.
Immunosuppressants have many side effects. These include harmful effects on the Caring for Patient After Kidney Transplantation, anemia, hypertension, and lipid disorders. Cosmetic changes may occur, especially when glucocorticoids are used, such as alopecia, acne, excessive hair growth, gingival hyperplasia, and obesity.
Deterioration of kidney function
Caring for Patient After hemodialysis or kidney Transplantation, deterioration of kidney function may occur as early as or late. Early causes are divided into prerenal ones like heart failure and hypovolemia, renal disorders are acute transplant rejection, nephrotoxicity of medications taken, and recurrence of the primary disease.
Symptoms of acute transplant rejection include a decrease in diuresis, an increase in blood pressure, pain in the area of the transplant, and feverishness. In laboratory tests, serum creatinine is increased by 10 to 25%.
The causes of late deterioration Caring for Patient After Kidney Transplantation function are divided into renal and non-renal.
Among the kidneys we mention, among others: recurrence of the underlying disease , nephrotoxicity of medications taken by the patient, late and acute transplant rejection, interstitial inflammation of the transplanted kidney caused by urinary tract infection.
The most common cause of loss of kidney transplant function is chronic transplant nephropathy. Non-renal, or urological, late loss of graft function causes obstructed urine, urolithiasis, and ureter stenosis.
Prone to infections
There are many complications Caring for Patient After Kidney Transplantation, therefore in this work, they will only be listed and briefly characterized. Caring for Patients After Kidney Transplantation is more prone to infections and infections because of intensive immunosuppressive treatment.
Both viral and bacterial infections are more common. In patients, we encounter opportunistic infections such as Toxoplasma gondii, Candida, Legionella, Pneumocystis carinii, and others.
Among viral infections, cytomegalovirus is the most important. There is also a recurrence of tuberculosis, fungal infections.
Caring for Patients After Kidney Transplantation Diabetes
Patients should have urine cultures routinely to prevent infection . Early identification enables more effective treatment of the patient. Other complications are post-transplant diabetes, i.e. diabetes that has developed in a person who did not have diabetes prior to surgery.
There may also be dyslipidemia, bone metabolic disease, and cardiovascular complications. Cancer is more common in patients who have had a kidney transplant. The most common is skin cancer. It is usually squamous cell carcinoma that rarely metastasizes. After surgery, just like before it, patients may have anemia.
Discharge from the hospital
Vaccines against influenza are recommended to be carried out once a year. Every three to five years pneumococcal vaccination should be carried out. The patient should also be vaccinated against hepatitis B depending on the number of antibodies.
After discharge from the hospital, the patient is looked after by a transplantation center. Visits take place once every 1 to 4 weeks.
The transplant outpatient clinic monitors the function of the transplanted kidney, modified immunosuppressive treatment, and the concentration of immunosuppressive drugs is monitored.
Urine cultures are performed and all complications related to kidney transplantation such as dyslipidemia, hypertension, anemia, and water-electrolyte disorders are treated. Vaccines with live microorganisms are contraindicated in transplanted patients.
A patient with kidney failure may be re-qualified for kidney transplantation. Due to a large number of risk factors, an assessment of the patient’s condition before re-transplantation must be very detailed.
When re-transplantation is not possible, the decision to choose peritoneal dialysis or hemodialysis should be made with the patient. There are no general contraindications as to the choice of renal replacement therapy in a patient who has had previous transplantation unless it results from the patient’s individual situation.
