This is the first of three articles in the Westmeath Topic about kidney transplants and the medication used. While I specifically deal with kidney transplants, a lot of the advice given in the next few weeks in the Westmeath Topic is true for any type of transplant (eg) Heart, lung, liver. Our kidneys are situated at the lower back behind the stomach, one is situated each side of the spinal cord. The lower ribs act as a cage for the kidneys preventing injury. Each kidney is approximately the size of your fist. The kidneys' main roles are to: filter waste products and excess water from the blood; produce hormones to regulate blood pressure and red blood cell production and maintain balance of water, salts and acid
Kidney failure is usually caused by a condition that prevents them functioning normally including the likes of diabetes mellitus, high blood pressure, polycystic kidney disease and glomerulonephritis. Injury and birth defects can also cause kidney failure. Damage to the kidneys from a condition like diabetes can take years before the effects of kidney failure start to be noticed. A sudden loss of kidney function is rarer but can occur due to some conditions. Kidney failure causes problems like a build-up of waste products and fluids and you end up developing side effects like tiredness and fatigue, oedema (swelling) in your ankles and face, nausea and a poor appetite.
Benefits of Kidney Transplantation
Kidney transplants are not a cure but they allow you maintain a normal standard of living. A successful kidney transplant should mean you no longer need dialysis. Energy levels increase as the new kidneys starts producing red blood cells. Fluid and diet restrictions should end.
When you contact your transplant team
*Your temperature is 38.3oC or higher. Do not take temperature reducing medication such as paracetamol until speaking to a member of your transplant team. Taking the likes of paracetamol to reduce your temperature means the transplant team cannot determine the level of temperature increase thus making possible rejection diagnosis more difficult
*Weight increases by 2 to 3 lbs in one day or 5 to 7 pounds over 3 to 5 days
*Urine output halves within a 24 hour period (i.e. 2000ml then 1000ml 24 hours later)
*Changes to urine pattern (ie) pain or bleeding while urinating
*Pain, swelling, tenderness or drainage in the area of the new kidney
*Nausea, vomiting or diarrhoea
*Cold or flu like symptoms (eg) sore throat, fever, chills etc (can be a sign of reaction to anti-transplant medication)
*Blood pressure is outside your regular readings, or below 90/60 or greater than 170/110
Let your dentist know you have had a kidney transplant. It is recommended to take an antibiotic before any dental work including cleaning. Experts advise Amoxicillin (2 grams) one hour before dental procedure. If allergic to penicillin, Clindamycin (Dalacin C®) 600 mg one hour before the procedure may be used instead.
Medication to avoid
Some medications interfere with the immunosuppressive medications. They can include cold, allergy, cough syrup or antibiotics. Antibiotics to avoid include clarithromycin (Klacid®), erythromycin and azithromycin (Zithromax®). Other drugs to avoid include the antifungal fluconazole (Diflucan®) and the heart rhythm drug diltiazem (Dilzem®).
AVOID grapefruit or grapefruit juice when prescribed Neoral®, Prograf® or Rapamune®, as it changes the metabolism of these medications. Avoid Magnesium Oxide or antacids such as calcium carbonate, Rennies®, Maalox® or Gaviscon® within 2 hours of taking your medications as they may reduce absorption of some drugs such as immunosuppresants and antibiotics.
Herbal preparations and supplements
There are very few scientific studies indicate whether herbs are effective, safe, or interfere with prescribed medications. Herbs can cause serious interactions and kidney problems for patients with renal failure and those taking medications after a transplant.
Possible issues with herbs: *Interactions between herbs and medications including reducing the effectiveness of transplant rejection medication. *Herbs may not be pure because of unregulated manufacture procedures. Herbs come from plants that may cause bacterial, fungal, or parasitic infections. There have been reports of herbs containing pesticides and metals including lead and mercury. *Some herbs are toxic effects to the liver, kidneys, and heart, especially when taken with other medication including changes in blood pressure, blood sugar and potassium levels leading to risk of bleeding and transplant rejection. *Dosages can vary from pill to pill, manufacturer to manufacturer or from what is stated on the label.
To be safe, transplant patients should avoid herbal preparations. To find what Over the Counter Medications are safe to use and which to avoid for Kidney Transplant patients check out my article on this in www.whelehans.ie.
To be continued…next week in the Westmeath Topic I discuss the medication prescribed to prevent transplant rejection including precautions to take with them
Become a donor
Give the gift of life, become an organ donor today. For an organ donor card, contact the Irish Kidney Association on LoCall 1890 543639 or logon to www.ika.ie
Disclaimer: Please ensure you consult with your healthcare professional before making any changes recommended
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