After the transplant, there are a few important things you should keep in mind to ensure that your new kidney is accepted by your body and lasts as long as possible. Let's take a look at a few things that you can do to help support your new kidney.
You may already have noticed that you have to take regular medication after transplantation. Immunosuppressants play a particularly important role. This is the name given to a group of drugs that slow down your body's own defense system (=immune system). This is to prevent your new kidney from being attacked and rejected by your own immune cells.
Despite taking immunosuppressants, however, you may still experience rejection reactions. The risk of rejection is especially increased in the first weeks and the first year after transplantation. There are different types of rejection reactions. In most cases the body recognizes the donated kidney as a foreign body, which activates the defense system. Usually, identifying “foreign material” such as bacteria or viruses is an important step in fighting off disease. But as always, there are pros and cons to everything. With regard to your donated kidney, this super-sensitive defense system can become a problem. That's because your body - as with other foreign material - creates immune cells that can then attack your new kidney.
This sounds pretty intense at first. However, the rejection reaction can usually be controlled with medication. In order to detect a rejection reaction early, your kidney function will be monitored closely, especially in the time right after your transplant. You will also receive a higher dose of your immunosuppressants at the beginning. Depending on your progress, the therapy can be gradually adjusted and your medication gradually reduced. However, you will always need to take immunosuppressants to ensure that your body accepts your transplant - stopping them completely is reckless and will lead to failure of your new kidney.
Nevertheless, it is especially important that you watch for possible signals from your body that may indicate a rejection reaction. These warning signs include fever (usually defined as a body temperature of 38°C or higher), reduced general well-being, pain in the area of the transplanted kidney, and decreased urine output. If you experience any of these symptoms, please contact the hospital where you had your surgery immediately. The professionals there can best assess what steps are needed next.
However, there are also a few general tips you can follow to increase the life of your new kidney. Let's take a step-by-step look at what you can do to keep your new kidney working for as long as possible.
Make sure you take your medications regularly.
You can make a big contribution to your new organ by regularly taking the medications prescribed by your medical team. To help you keep track of your medications, you can take a closer look at the medication documentation feature in the Mizu app. It will help you stick to your personal medication schedule.
Keep track of your diet and weight
You can also do something good for your new kidney and your body by adopting a healthy lifestyle. In particular, you should try and avoid gaining excess weight and diabetes in the long term. In addition to the negative effect on your general health, both can have a negative impact on the function of your transplanted kidney and thus also reduce the life span of your new kidney. So try to keep your weight and blood sugar in the green zone. Specifically, your body mass index (=measure for estimating body fat percentage) should be below 30 kg/m². As far as your blood sugar is concerned, the fasting blood sugar is of particular interest. For this purpose, the amount of sugar in your blood is determined in the morning - after you have not eaten for at least 8 hours. In healthy people, the blood glucose value should be less than < 100 mg/dL (< 5.6 mmol/L). In addition, the long-term blood glucose value (=HbA1c) is usually determined. This value is less than < 5.7 % (<3 9 mmol/mol Hb) in healthy people.lue is less than < 5.7 % (<3 9 mmol/mol Hb) in healthy individuals.
Especially after transplantation and with the often new or regained freedom in terms of your diet, this can be a bit of a challenge at first. Therefore, let's take a look at various tips and tricks that can help you.
Motion is lotion
Regular exercise keeps you fit and healthy. It increases your endurance and has a positive effect on your weight. But that's not all: regular exercise helps you reduce stress and can also improve your mental health. Don't worry, this doesn't mean that you have to become a professional athlete. In the first 3 months directly after the transplant, it is important that you are and remain mobile, but sports are not recommended during this time. After that, it is best to approach exercise and sports step by step in consultation with your nephrologist. You can start, for example, with short walks. But exercise can also be perfectly integrated into everyday life. Just skip the elevator and take the stairs, or don't park directly in front of your house, but a little further away. Even though you may not notice a difference at first, don't be discouraged. In the long run, you'll notice a positive effect on your health.
If your transplant function is stable, regular exercise should be your clear goal to also protect your cardiovascular system from disease. To do this, you should exercise five times a week for about 30 minutes in a way that makes you sweat easily. This can be different things - of course always adapted to your personal fitness level. For the sake of your kidneys, you should avoid high-risk sports such as downhill skiing or martial arts. But how about a round of jogging, cycling, moderate mountain hiking or swimming? For many people it is also more motivating to do sports in a group. Maybe you have someone in your circle of friends and acquaintances with whom you can make regular appointments? Or there is a sports offer in the form of courses or even a sports club?
Regulate your calorie intake
Although the newfound freedom in terms of nutrition after transplantation may seem tempting, it's important to keep an eye on your calorie intake. To keep track of this, feel free to check out Mizu's food diary. For people of normal weight, a guideline for calorie intake after transplantation is 30-35 kilocalories per kilogram of body weight (=kcal/kg). If your medical team has advised you to reduce your weight, it is helpful if you eat fewer calories than your body consumes (=calorie deficit). In addition, you should of course get enough exercise. As a rough guide, if your are overweight, your calorie intake should be 500 - 1,000 calories below the 30-35 kcal/kg daily recommendation. Since, as always, many different factors play a role in nutrition, it is best to talk to your nephrologist about this topic. He/she can also recommend a nutritionist - the experts in this field.
Keep your blood pressure under control
Besides diabetes, high blood pressure (=hypertension) is one of the main causes of chronic kidney disease (=CKD) and thus also of the need for a kidney transplant. It is therefore not surprising that more than half of all people with a new kidney still suffer from hypertension. But whether you have your own kidney or a donated one, too much pressure in your blood vessels has a negative impact on your kidney function. Ideally, your blood pressure should be below 130/85 mmHg. You will learn about how you can can influence your blood pressure yourself in the following sections.
Monitor your blood pressure
Keep an eye on your blood pressure readings over a longer period of time. This will help you and your healthcare team figure out what range your readings are settling into. Based on this, the right steps can be taken. The documentation in the Mizu logbook can also help you. There you can regularly enter your blood pressure values so that you can evaluate them in your next consultation with your nephrologist. As you already know, your blood pressure should ideally be below 130/85 mmHg. But what do these two values mean again?
Your blood does not flow evenly through your body, but is pumped through your body by your heart. The first value is the maximum pressure that occurs in your vessels. This value is also called systolic blood pressure. The second value is the lowest pressure in your vascular system when the heart is not pumping blood out of the left ventricle, called diastolic blood pressure. The unit of measurement for blood pressure is millimeters of mercury (=mmHg).
Make sure you get enough exercise and maintain a healthy weight
As we've already learned, exercise and a healthy weight have a positive impact on your health and the life of your new kidney. In addition to the benefits we've already looked at above, exercise and a healthy weight also have a positive effect on your blood pressure levels. Now that's quite a few benefits at once, which is why it's worth starting right away!
Caution with salt consumption
Reducing your salt intake can also help you lower your blood pressure. But why is that? Sodium chloride (=table salt) is a mineral that influences water balance in your body. Above all, increased amounts of sodium can increase the volume of fluid in your vascular system. As the fluid in your vessels increases, so does the pressure – that is, the blood pressure. For this reason, you should be careful not to consume more than 5 grams of salt per day (2.3 grams of sodium per day). Achieving this is often not so easy - especially if you like to use ready-made foods. In addition to sugar, they often contain a lot of salt. That's why you should cook as much as possible yourself. Instead of salt, you can then, for example, resort to various other spices to flavour your food!
Don't forget your medications
If lifestyle changes - especially more exercise and a healthy diet - are not enough to control your blood pressure, you may need to take additional medication. To ensure that the medications work properly, it is important that you follow your prescribed medication schedule exactly. For a better overview, you can best use the medication features in the Mizu app.
Protect yourself from infections
Your immunosuppressants are essential to prevent your new kidney from being rejected by your body. However, this also means that your immune system no longer reacts as it normally does to pathogens such as bacteria, viruses or fungi. You are therefore more susceptible to infections and more severe courses of disease than other people. To protect yourself preventively (=prophylactically) from some of these pathogens, you will often receive additional medication directly after the transplant.
You can also do a lot to protect yourself from infections. It is particularly important that you observe maintain good hygiene. You should pay particular attention to regular hand washing, especially before cooking and eating. One or two things are also important when choosing your food. For example, it is recommended to avoid raw meat, raw fish and raw eggs. More detailed information on how to avoid infections can be found in other articles on the Mizu app.
In general, try to pay attention to your body's signals. If you feel unwell, go to your doctor early and get checked out. The earlier you respond to infections, the better they can be treated!
Cook Mediterranean
When it comes to nutrition, a Mediterranean diet is especially recommended for you. This means lots of fresh fruits and vegetables, cooking with olive oil and choosing fresh fish over meat. The Mediterranean diet provides your body with many vitamins and omega-3 fatty acids and thus contributes to better health. In addition, Mediterranean cuisine is often cooked with various herbs and spices instead of salt, so it is particularly suitable for you in this respect. If you are still looking for the right recipe ideas, then feel free to take a look at the Mizu app. There you will find a variety of different dishes that are particularly well suited for you.
Make sure you drink the right amount of fluids
During dialysis, the recommended amount to drink is very individual and usually lower than for people with healthy kidneys. After transplantation, you try to drink 2 liters of fluid every day. Depending on kidney function, this can sometimes be more. For precise recommendations, it is best to speak directly with your medical team. Since this change is not so easy at the beginning, you can get support with the Mizu app. The drinking diary helps you to keep track of your fluid intake. Have you actually drunk enough today? If not, go get yourself a glass of water right now!
Go for a checkup
We've outlined some tips to best protect and support your new kidney. Regardless of this, however, it is extremely important that you attend regular check-ups with your treating team. There, the most important (blood) values are checked and your kidney function is monitored. This is extremely important in order to be able to react to changes early on. So schedule your checkup appointments conscientiously and mark them in your calendar.
Phew, that was quite a lot of information at once. In a quiet minute, it is best to go through everything again step by step. If something is unclear to you, you can of course always ask your treating nephrologist.
