Important "Lesser Known" Issues Chronic Kidney Disease Patients Should Consider Before Transplant

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When Chronic Kidney Disease (CKD) patients are considering receiving a Kidney Transplant they must factor in that the treatment has its own set of advantages and problems which should be weighed carefully. Some people have a Kidney Transplant and their donated kidney works well with few problems, but this is not always the case. The following are important things that every person with CKD should consider when contemplating a Kidney Transplant. 

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Surgery: There are certain risks with any surgery. Possible risks include a reaction to anesthetic, an infection, or physical problems that arise during or after surgery.

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Rejection Problems after a Kidney Transplant: Your body naturally tries to reject (get rid of) things that are foreign to it as part of your immune response. Antibodies and white blood cells (lymphocytes) attack viruses, fungi, bacteria, and other foreign substances (such as a transplanted kidney). Immunosuppressive drugs suppress the immune system of the body. You will take these drugs as long as you have your transplant. This is done to try to fool your body into accepting the new kidney and not rejecting it. Modern versions of these drugs have greatly reduced the number of rejections, but rejections do still occur.

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Immunosuppressive Drugs: All immunosuppressive drugs have side effects because your body’s suppressed (lowered) immune system is less able to fight off germs, bacteria and other health problems that may arise. Common side effects include more facial hair; changes in body fat that cause fullness in the cheeks, stomach, and back; mood swings; short term memory loss; increase in appetite; liver damage; and bone disease. In other cases immunosuppressants can cause other health problems to develop such as diabetes, cataracts, peptic ulcers, and bone and joint problems. It is not known ahead of time if you will develop any of these problems or how serious they might be. All side effects vary from person to person and depend on the amount of each drug being taken. Over time, your doctor lowers the amount of drugs needed, which reduces negative risks. Diet and exercise often help.

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Payment: Most patients who are able to have a Kidney Transplant have their hospital costs paid by Medicare and private insurance companies. These sources also usually pay 80% of your doctor's fees and most of your lab fees. After discharge from the hospital, Medicare pays 80% of the costs of outpatient follow-up medical visits for three years and immunosuppressive drug charges for 36 months. This leaves the patient to pay for the expensive drugs out-of-pocket after that time period. If the patient cannot afford the drugs after the 36 month time period, the transplanted kidney will stop working and the patient will either return to more costly dialysis treatment, or will die.

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Living Donor: These funding sources will also pay the costs of the medical work-up before surgery for Living Donors and Medicare (if the person getting the kidney is eligible for Medicare) will pay 100% of the hospital and surgeon costs for removing your Donor’s kidney. Your Kidney Transplant Center's Financial Coordinator should be able to answer any questions you may have about funding for transplant costs.

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Limits to Your Diet: People with a transplant usually eat a normal diet. You may still need to be careful of the amount of sodium (salt) and potassium in your diet. You also need to watch the amount of calories you eat to avoid gaining too much weight which could cause your newly transplanted kidney to fail.

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The primary benefit of a successful Kidney Transplant is that dialysis is no longer needed which generally means an extended and improved quality of life. Transplant patients often return to work within eight weeks of their surgery. Kidney Transplantation frees a person with CKD to resume a normal life including work, travel, sports and more. However, Kidney Transplantation is not without its fair share of risks. For example, it requires major surgery, you have to wait for a donor or cadaver kidney, your body may reject the kidney, and you will need to afford immunosuppressants. encourages you to discuss all these issues with your Nephrologist and carefully think about them as you consider obtaining a Kidney Transplant.

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Reference: "Living with a Transplant." Northwest Kidney Centers - Live. Learn. Hope.