Sunday, April 21, 2024

Long-term outcomes and quality of life after kidney transplant

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Kidney failure is not the end game, kidney transplant is always an option. Once you receive a kidney transplant, it is a life-changing experience. Though it is a new lease of life, there is a lot of anxiety, both mental and physical, associated with receiving a new organ. Having a foreign organ in one’s body can present a unique set of problems that would need adjustment and the immediate post-transplant period especially might be stressful. Individual experiences may vary as it depends on several things, like the immediate functioning of the transplant kidney, and the overall health condition of the patient before transplant, to name a few.
While most kidney transplants are successful, there are chances that sometimes it may not function well. This can happen because the body might not accept the new kidney, patients can develop infections, or there might be other health problems. Every transplant recipient is put on life-long medicines to prevent the rejection of the transplanted kidney and close monitoring of the blood parameters including levels of these medicines is essential to pick up issues early. By following the instructions and regular follow-up as advised by the treating transplant physicians and nephrologists, patients can lead a near-normal and fruitful life.
When kidneys are not functioning and reach the stage called End Stage Kidney (Renal) Disease (ESRD), life cannot go on without Renal Replacement Therapy which is either by dialysis or kidney transplantation. This is the stage at which usually transplantation is advised, but there are some situations, especially in children wherein kidney transplantation can be done before dialysis requiring stage, known as pre-emptive transplantation.
Dialysis itself is generally not painful, as the process is performed using machines that filter the blood to remove waste products and excess fluid. However, some people may experience discomfort or complications related to the dialysis procedure, such as low blood pressure, muscle cramps, or nausea. Additionally, individuals may find the time-consuming nature of dialysis treatments and the restrictions they impose on their lifestyle to be challenging.
Kidney transplantation is generally considered the preferred treatment option for eligible candidates with end-stage kidney disease, as it offers the potential for a better quality of life and improved long-term outcomes compared to dialysis. After a kidney transplant, individuals often experience enhanced quality of life compared to when they were on dialysis. This improvement stems from restored kidney function, which helps regulate blood pressure, fluid balance, and electrolyte levels. With better kidney function, recipients typically face fewer complications such as infections, cardiovascular issues, and bone disorders. Many also report feeling more energised and less fatigued, enabling them to engage in daily activities more comfortably. Additionally, the transplant often comes with fewer dietary restrictions, granting recipients greater freedom in their food choices and contributing to an overall sense of well-being.
With proper medical care, including adherence to immunosuppressant medications and regular follow-up appointments, many kidney transplants can function successfully for years, providing recipients with not only improved quality of life and the chance to embrace a brighter, healthier future but also better longevity. If we take 100 patients on dialysis today after 10 years only 20 will be alive while with kidney transplants 80 will be alive and doing well. Kidney transplant recipients both men and women have better sexual health, and many get married, have children, and lead a normal life after transplantation compared to those on dialysis.
For individuals who have undergone kidney transplantation, it’s essential to follow medical advice to maintain their health. When it comes to physical activity, it’s generally encouraged to engage in regular exercise, such as walking, swimming, or light aerobics, to promote overall fitness and well-being. Except for contact sports kidney transplant recipients can do almost everything. Alonzo Mourning, the famous basketball star won many tournaments after a kidney transplant.
In terms of diet, recipients should follow a balanced and nutritious diet rich in fruits, vegetables, lean proteins, and whole grains to support kidney function and overall health. It’s crucial to limit sodium, potassium, and phosphorus intake, as well as avoid excessive alcohol consumption and smoking, which can negatively affect kidney function and increase the risk of complications. Additionally, recipients should adhere to their prescribed medications, attend regular medical check-ups, and promptly report any changes in health to their healthcare provider to ensure the long-term success of the transplant. Rightly said by a Scottish Nephrologist, “Kidney transplant is like marriage: boon for many, curse for some but a risk for all”.
Kidney transplantation is a new lease of life for individuals facing end-stage kidney disease. Beyond simply replacing a failing organ, it offers recipients the opportunity to reclaim their health, vitality, and independence. With improved kidney function and better control of their health, recipients can enjoy a higher quality of life, and long and fruitful years marked by increased energy, emotional well-being, and freedom from dietary restrictions. However, this newfound lease on life also comes with responsibilities. Transplant recipients must prioritize their health by adhering to medical advice, including maintaining a balanced diet, engaging in appropriate physical activity, and diligently taking prescribed medications. By doing so, they can maximise the long-term success of their transplant and embrace the future with optimism and resilience.

(The author, Dr. Sundar Sankaran, is a Program Director at Aster Institute of Renal Transplantation, Aster Whitefield Hospital.)
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