Common causes of End stage kidney disease/kidney failure
Diabetes Mellitus (DM) and Hypertension (High blood pressure) are the two most common causes of Kidney Failure (ESRD) and accounts for 40 to 70% of the causes. There are several other reasons of kidney failure like autoimmune diseases, congenital diseases, and long-standing untreated kidney(s) obstruction (just to name a few)
The kidney does not fail in a day, it happens over time and gradual leading to the loss of function. In fact, in many patients, people are unknown to the fact and the problem is only known once it becomes severe.
Kidney transplantation or renal transplantation is a kind of organ transplant (of a kidney) in a patient whose both kidneys are damaged fully and does not bear any chance of recovery. Referred to as an end-stage kidney disease, under such cases, both kidneys of the diseased person fail to function.
“Pre-emptive” or “Early” kidney transplant! What and Why?
Kidney failure leads to dialysis in most patients. However, in some cases people opt for a transplant directly without going into the stage of dialysis, which largely depends upon availability of a donor. This is referred as a ‘pre-emptive’ or ‘early transplant’.
It allows you to avoid dialysis altogether and its related complications.
Some research indicate that early transplant leads to better health and recovery, allowing early work renewal and better quality of post-surgery life due to avoidance of dialysis related problems.
Your normal kidney function has stopped, implying your body needs a new kidney. Placing a healthy functioning kidney into your body, for substituting the kidney which has stopped functioning, is attained by a kidney transplant surgery. This is required since the kidney of the patient becomes incapable of performing the functions it must do for the body to survive.
Confirmed studies indicate that people who get a kidney transplant live longer than those on dialysis and have better quality of life. Recent years have shown tremendous improvements in anti-rejection (immunosuppressive) medications and hence better kidney transplant success rates.
– No restrictions on diet except for primary disease itself (like for diabetes)
– Health and energy improves over a period
– Reversing of life back to normal as before
– Side effects of surgery (usually temporary)
– Anti-rejection medications (doses and number of drugs will reduce over time and hence the side effects)
– Higher risk of infections (for initial period of time and will gradually reduce)
Who can get a kidney transplant?
Kidney transplantation can be done till upper age limit of 65 years or at least 5 years of life expectancy and the patient should be healthy enough to go for such kind of surgery. Other health conditions and mental readiness are also a key aspect in such kind of surgeries. A thorough medical evaluation is done to find out whether someone is a right candidate for surgery or not and the possible difficulties which may arise during and after surgery.
It is highly recommended to have consultation with Urologist/kidney transplant surgeon before taking first step for the procedure.
– After-effects of surgery
– Risk of infections
– Anti-rejection medications
In case of a kidney transplant, the body might reject the kidney. Simply put, this is because your body tends to fight germs and viruses (immune system). In a similar way, an external or new kidney might get attacked by the body. This in turn, needs anti-rejection medications.
Kidney transplant is associated with fewer after-effects which must be discussed with your doctor before the surgery.
This person can be a blood relative (like brother/sister/mother/father/son/daughter) or spouse. A healthy person who donates a kidney can live a normal life with the one kidney that is left. Donor must be above 18 years of age, willing to commit to the living kidney donor evaluation process and surgery. Final selection and acceptance of the donor depends after further consultation and tests with Urologist/kidney transplant surgeon.
Deceased organ donation is the process of giving an organ at the time of the donor’s death(Brain dead), for the purpose of transplantation to another person.
What all is involved in a kidney transplant?
– Retrieving health kidney from donor through keyhole (laparoscopic)/Open surgery
– Placing donated kidney into the lower Right(preferable)side abdomen of recipient
– Connecting it to blood vessels going to the lower limb and ureter to the bladder
– Prescribed anti-rejection medicines
– Suggested healthy-diet
– Home within 1 to 2 weeks post surgery
Contrary to the general conception, kidney transplant does not involve removing the patient’s/recipient’s kidneys. The kidney from the donor is placed into the body’s lower abdomen(preferable Right side) and connected to the appropriate blood vessels and bladder. In case, you have been donated a kidney from a living donor/deceased donor, it usually starts functioning rapidly((90% cases).
After a kidney transplant, be extra cautious about the ‘follow-up’!
For your transplant to be successful and transplant kidney keep on functioning properly, you will need regular check-ups for the entire life. In addition, blood tests are a must several times in a week initially and the frequency will decrease gradually.
With time, the need for frequent check-ups reduces with the correct dosage of anti-rejection (Immunosuppressive) medications.
In case of delayed functioning of transplant kidney in few select patients, you might need support of dialysis for some time along with stepping up/change of anti-rejection medicines.
What are anti-rejection/immunosuppressive medicines prescribed during and after kidney transplant?
Anti-rejection or Immunosuppressive medicines
– To keep immune system less active
– To stop body from rejecting the kidney
– To be taken as long as Transplant kidney works
To stop the body’s immune system from rejecting the replaced or donated kidney, the patient must be put on anti-rejection medications. However, these anti-rejection medicines have certain side effects, but are manageable. Discuss the detailed scenarios related to your medicines with your urologist/kidney transplant surgeon.
Beware! rejection is still a possibility post kidney transplant
– Body can reject the donated kidney
– Lesser rejection chances if donated kidney has been placed for long
– Absence of clear signs/symptoms is possible
– Blood tests important
-Transplant kidney biopsy may be needed to ascertain the type and treatment for rejection
Symptoms of acute rejection may include (though not specific):
– Decreased urine output
– Weight gain
– Pain over kidney
Rejection by the body after the kidney transplant procedure is possible. But the good news is, medical treatments are now available for such issues. Inform your doctor as soon as you face any kind of difficulties or symptoms of rejection
Rejection after a kidney transplant: myths vs reality
The cases of rejection after a kidney transplant have now dropped significantly. There has been a lot of improvements in immunosuppressive medicines which helps your body retain the transplant kidney. Also, the risk of rejection varies from person to person and it becomes very important to have regular check-ups from your doctor to take good care of your kidneys and make sure you are not having rejection.
Go for a ‘heart-healthy’ diet after kidney transplant
– Low fat diet
– Normal/Low salt
– Adequate fluids to avoid dehydration
– High-fibre foods
-Fresh/Seasonal fruits and vegetables
– Proper dietary supplement (like Calcium and vitamin D) as advised by your doctor
Yes of course, a healthy diet post kidney transplant surgery is a must. But unlike other surgeries, after a kidney transplant, there are not any major restrictions or additions to a normal healthy diet. In case, the patient has diabetes or any other health problem, dietary restrictions regarding the same must be adhered with.
Coming back to your work routine depends upon your job role and the speed of your recovery. As every person has a different kind of body and other medical conditions, most people can return to work within eight weeks or more after their transplant. Your doctor and transplant team will help you decide when you can get back to work.
You can expect better and satisfactory Sexual relations after a Kidney transplant. In addition, the condition of fertility tends to improve after a transplant. Couples (in which one spouse had transplant) can have successful pregnancies and healthy child after transplants. It’s best to talk to your doctor when considering having a child.
While women should avoid becoming pregnant too soon after a transplant in most cases, they are usually advised to wait for a year or two for the same( and depends on case to case basis). Also, a proper consultation from your doctor is advised to ensure proper family planning.