Medication of patients with renal failure

The human body has lines of defense that protect it from harmful influences, including the external line such as the skin and the mucous membranes lining many body organs, and the internal line known as the immune system, which consists of white blood cells and antibodies secreted by some of these cells. We know that a kidney transplant patient needs to undergo many tissue compatibility tests before the operation, and despite these tests, the transplanted kidney is still considered a foreign organ to the body, prompting the immune system to attack it (i.e., reject it). For the operation to be successful, the immune system must be suppressed, a process known as immunosuppression, so that it does not attack the transplanted kidney.

➡️And immune suppression requires two stages:

Rehabilitation:

And strong doses of these medications are usually given intravenously before the surgery and sometimes during the first few days after the surgery.

Continuity:

In it, oral medications are given daily to maintain a low performance rate of the immune system, allowing the transplanted kidney to be accepted without rejection while keeping a certain level of body immunity that works against many microbes it may encounter.

Thanks to scientific advancement, many of these medications have been discovered, making it possible to administer them according to each patient's condition, whereas in the past, the options were limited to two or three medications given to all patients, which could negatively affect their health if side effects of these medications appeared.

➡️Among these medications:

-Prednisolone.

- Imuran.

- Cellcept.

- Neoral.

- Prograf.

- Rapamune.

The doses of these medications are gradually reduced to the lowest amount by the end of the first year after the transplant.

Preventing infections for kidney transplant patients:

• Immunosuppressive drugs inhibit or reduce the body's immunity, which is necessary to prevent kidney rejection. At the same time, a certain level of immunity must be maintained to fight various microbes. Therefore, the treating physician conducts regular tests to ensure the levels of these drugs in the blood and their effectiveness, and thus tries to balance the difficult equation of preserving the kidney and preventing infection.
  
  
• However, the patient may go through periods where their immunity decreases to a level that allows for infections to occur. This can be due to general reasons like any other person, such as cold spells, seasonal changes, and malnutrition, or specific reasons like increasing medication doses to suspect or treat kidney rejection, or the necessity of using certain medications that enhance the effect of rejection-preventing drugs on the immune system. We should not forget that some infections, especially viral ones, can significantly lower the body's immunity.
• The body's immunity is at its lowest during the first six months after the transplant, so antiviral, antibacterial, and antifungal medications are prescribed to the patient during this period to help reduce the likelihood of infections. Patients are generally advised to avoid contact with individuals who have infectious diseases, especially children, and to stay away from crowded and poorly ventilated places. They should consume fresh home-cooked meals and avoid ready-made meals available in the market. It is important to consult a doctor immediately if there is an outbreak of infectious diseases in the patient's surroundings.

Vaccination and kidney transplantation:

Following vaccination schedules according to the advice of the treating physician is an essential element for preventing bacterial and viral diseases that a kidney failure patient is exposed to before and after undergoing a transplant. This is done in consultation with the treating physician and the surveillance and virology department at the hospital. As a basic rule, vaccinations derived from a live attenuated (i.e., inactive) microbe, which are known at various vaccination centers, cannot be administered.

➡️Notes :

1-That kidney patients often also suffer from high blood pressure

(Therefore, the amount of salt consumed should be reduced, especially in canned cheeses, processed meats, and ready-made meals).

2- He also suffers from high blood cholesterol or triglycerides.

Therefore, the amount of fats he consumes, which are often found in full-fat dairy products, meats, fried foods, chocolate, and nuts, should be reduced.

3-The rising rates of diabetes in our country, especially since it is one of the main causes of kidney failure, mean that a significant percentage of kidney transplant patients suffer from this disease.

Therefore, it is necessary to adhere to a special diet that prevents high blood sugar levels and, more importantly, prevents the emergence of new cases among those predisposed to this disease due to genetic factors or other health reasons.

4- Kidney transplant medications may be responsible for some nutritional problems such as increased appetite, weight gain, high blood pressure, and diabetes. These can be managed by following the necessary diet for these various health issues. They may also cause gastrointestinal disturbances, leading to dehydration or malnutrition.

➡️Contraceptive pills:

There are side effects of contraceptive pills that are not suitable for kidney transplant patients and may cause health problems for them, so they should be avoided except in limited cases with the approval of the treating nephrologist.