Have you successfully made it through your kidney transplant and are now wondering which medications are relevant for you after the transplant? What about blood pressure and diabetes medications, phosphate binders and potassium binders? And what about immunosuppressants? We would like to take a look at the answers to these questions together so that you are not alone with your new medication line-up.
After a kidney transplant, it is important to take certain medications to keep the new organ functioning and to avoid complications. Some medications you may already know from your time on dialysis. Other medications are new to you. Let's take a look at exactly which medications are important for you and why.
Which medications are still important after transplantation?
It is important to note that your personal medication depends highly on your individual case and your personal secondary diagnoses (e.g. high blood pressure, diabetes, etc.). The following sections are intended to give you a general overview of the most common medications after transplantation. Please note, of course, that these are in no way recommendations for your own therapy or advertisements for medications. Your individual medication will always be determined by your medical team and as such, may vary. Recommendations of your medical team regarding medications always have priority over the information given here.
In general, medications that you need to take due to pre-existing conditions are usually important for you and your health even after transplantation.
1. Blood pressure medication
High blood pressure can be the cause and consequence of kidney insufficiency. The high pressure in your blood vessels can cause long-term negative consequences and damage to your cardiovascular system. Therefore, it is all the more important for your new kidney that you continue to take your blood pressure medication if you have been prescribed it. Additionally, you should also try to keep your blood pressure in a healthy range through physical activity. But what exactly do we mean by healthy range?
For you, a target value of ≤ 135 / 85 mmHg applies after successful transplantation. However, it is best to talk to your doctor about your individual target value. Depending on various factors (e.g. previous illnesses), it may differ slightly. To keep an eye on your blood pressure, you should measure it at regular intervals. If you notice that the values are often above your target value, it is best to consult your doctor. It may be necessary to adjust your medication.
2. Diabetes medication
If you were already taking medication to treat diabetes before the transplant, these medications are usually also important for you after the transplant. They ensure that your sugar balance remains under control. There are different medications to treat diabetes, depending on whether you have type 1 or type 2 diabetes. If you want to learn more about these types, feel free to read more articles about them in the Mizu app.
3. Phosphate and potassium binders
Whether or not you need to take phosphate and potassium binders after your transplant depends on how well your new kidney is working. For this reason, it is important to check with your doctor at regular intervals to see how your phosphate and potassium levels are developing. But you don't have to worry: Your nephrologist will assess whether you need to take phosphate and potassium binders.
These medications are added after the transplant
To prevent your body from rejecting your new kidney, it is important to take so-called immunosuppressants after the transplant. As the name already suggests, they turn down (=suppress) the effect of your defense system (=immune system). This suppression of your immune system allows your new kidney to escape the radar of your defenses and to arrive in your body in a relaxed state.
If you notice possible side effects (e.g. diarrhea, cold symptoms, weight gain, etc.) when taking your immunosuppressants, please contact your nephrologist. It is important that you follow the prescribed medication schedule as closely as possible. Irregular intake or omission of medication can have a negative effect on your new kidney.
What do I need to keep in mind when taking immunosuppressants?
So now you already know that immunosuppression is vital for you after transplantation. There are various points that you should take into account when taking immunosuppressants so that they work optimally and your new kidney can acclimatize well in your body. Let's take a closer look at exactly what these points are.
- Make sure you take your medication correctly: It is important that you take your medication exactly according to the medication schedule provided by your transplant team. If you forget to take your medication, it is best to contact your nephrologist or the transplant center to discuss how to proceed. Increasing or doubling the next dose on your own can be dangerous and should ideally be avoided.
- Adjustment of medication: Your nephrologist and the transplant center determine certain target values after the transplantation as to what the concentration of your immunosuppressants in the blood should be. Especially in the period immediately after the transplantation, it may happen that your medication needs to be slightly adjusted in order to reach the target values. Your nephrologist will give you more detailed information about this.
- Avoid grapefruit juice or St. John's wort tea: Both drinks can increase or decrease the concentration of your immunosuppressants in the blood and should therefore not be part of your diet.
- Take painkillers and antibiotics only after consultation with your doctor: These drugs can also influence the level of immunosuppressants and should therefore only be taken after consulting a doctor. In case of doubt, it is always better to ask your nephrologist once too often than once too little!
- Always state your "transplant status" when visiting your doctor: It is also important for other doctors (e.g. dentists) and before operations to know that you have been successfully transplanted and are now taking immunosuppressants. They must also take this into account when administering medication. In addition, this information helps your doctor to contact your nephrologist immediately in case of possible complications.
- Support from the Mizu app: The Mizu app can also help you to take your medication regularly and correctly. You can store your personal medication schedule and be reminded to take your medication
What are the side effects of immunosuppressants?
So now you know what you should look out for when taking immunosuppressants. Finally, let's take a look at the side effects that can occur with immunosuppressants and what you can do about them.
1. Increased risk of infection
One of the most common side effects of immunosuppressants is an increase in the risk of infection. Because immunosuppressants weaken the immune system, the body may become more susceptible to infection. It is important to take extra precautions while taking immunosuppressants to prevent illness or infection. For more information, see the other blog articles on this topic.
2. Cancer screening
Another possible side effect of immunosuppressants is an increased risk of tumors, especially skin tumors. With long-term use, these drugs can increase the risk of cancer. For this reason, regular check-ups are especially important for you. You can find out exactly which ones are recommended for you in the article "Important after transplantation: cancer screening". Also make sure to protect yourself sufficiently from the sun. Wearing hats and sunscreen with a high sun protection factor are especially important for you. You can set a good example for your family and friends. These protective measures are recommended for everyone, regardless of a transplant.
3. Kidney function
At high doses, immunosuppressants can also worsen kidney function. When drugs have such an effect on your kidney, it is called nephrotoxicity. To avoid this, it is important to take your medications exactly as prescribed by the transplant center and to monitor your kidney function regularly. If you follow the exact instructions of your nephrologist, you do not have to worry about this.
4. Deviations in laboratory values
Increased liver enzymes and blood count changes are other possible side effects of immunosuppressants. This can lead to the drug having to be discontinued or the dosage being reduced. However, your nephrologist also keeps an eye on these values and will make the right adjustments for you in the event of any changes. It is therefore important that you attend your regular check-ups diligently.
5. Excessive weight gain
Cortisone medications in particular can significantly increase your appetite and may even cause you to gain weight. Make sure you continue to eat a healthy, balanced diet and get enough exercise.
6. Diabetes
Some people develop diabetes only after transplantation (= post-transplant diabetes mellitus). This can be triggered by the immunosuppressants, for example. Therefore, your blood sugar level will be checked regularly, especially at the beginning. In this case, you can also try to positively counteract the development of diabetes by, for example, getting enough exercise and eating a healthy diet.
As you can see, by taking various precautions you can partially prevent the possible side effects and reduce the risk of their occurrence. You will find that you can now enjoy much more freedom after the transplant than when you were on dialysis - and you will quickly get used to the precautions.
