Before and After PKD Transplant
Reasons to Remove Natives
Simultaneous Renal Transplantation and Native Nephrectomy in Patients With
Autosomal-Dominant Polycystic Kidney Disease
Conclusion. "In patients with ADPKD native nephrectomy of massively enlarged kidneys may be safely performed during the transplant procedure
with no repercussions on the length of hospital stay, graft short- and long-term function and patient survival. However the procedure leads
to a longer operative time and greater need for fluids and blood products."
There is some continued debate among PKD'rs about the removal of their native polycystic kidneys following a kidney transplant. For some PKD'rs
the removal of native polycystic kidneys has resulted in a dramatic lowering of elevated blood pressures. This lower blood pressure remains
consistently normal and is much easier to control. Energy levels seem to be tremendously improved possibly due to the elimination of the weight
of huge cystic organs. Polycystic Kidneys can add 40 extra pounds.
The remaining native polycystic kidneys if left behind continue to have a diminished blood supply. This lowered renal blood supply,
stimulates polycystic kidneys to pour out renin. Renin causes blood pressure to go up, up, up, raising blood pressure sky high.
Some have experienced blood pressure spikes.
The renin-angiotensin-aldosterone system and autosomal dominant polycystic kidney disease
Before Transplant
Omega 3's Hemp seed Oil Capsules
CMV - possible pre-transplant therapy
Anti coagulation prevent venous thromboembolism
What medications, supplements, and foods to stop?
Check out the paired donor exchange program
Ask if you can get a baseline bone density before your transplant.
After Transplant
What studies or biopsy will follow any possible graft rejection?
Eyes
Bone Density
Diabetes
Kidney Stone
Weight gain
Swelling of Extremities
Venous Thromboembolism Rates Climb After Hospital Discharge
HAMILTON, Ontario, July 23 — Patients are more likely to develop venous thromboembolism after hospital discharge than during their stay, and most get no prophylactic treatment.
Although as many as 10% of hospital deaths can be attributed to pulmonary embolism, most cases of venous thromboembolism are diagnosed in the three months after hospital discharge.
Findings emerged from a study of 1,897 patients with an episode of venous thromboembolism confirmed from medical records of in the Worcester, Mass., metropolitan area during 1999,
2001, and 2003. In all, 73.7% (1,399 patients) developed venous thromboembolism as outpatients. By comparison, only 26% (498 patients) developed the clots while hospitalized. Among
516 patients with a recent hospitalization who subsequently developed venous thromboembolism, fewer than half (42.8%) had been given anticoagulant prophylaxis during their
hospitalization.
After Transplant Diet
Ask about an appointment with the renal dietitian
Ask post transplant diet
What ↑ kidney blood flow?
Laying on your back ↑ kidney blood flow
Certain blood pressure lowering medications ↑ kidney blood flow
Remain Alkaline
Should you need potassium post transplant ask for potassium citrate
Drink adequate water. Ask if 3 liters is a good quantity?
Minimize dairy, animal proteins, and soy
Enjoy leafy vegetables, fresh fruits and many plant based foods
Eliminate salt, sugary, starches, and combining starches with proteins
The following will ↑ body weight. Post transplant avoid these starch and protein combinations:
Sandwiches
Meat and potatoes
Nut breads
Fish and rice
Pasta and meatballs or cheese
Eat animal proteins in small quantities
Gorging like a lion ↓GFR newly transplanted kidney
Diabetes can be a side effect of some of the transplant medications
One is called steroid diabetes
Tacrolimus and cyclosporin sometimes produce diabetes
After Transplant Immunosuppresive Agents and Diabetes
Sirolimus - treatment with the anti-rejection drug sirolimus may lead to increased risk of diabetes in kidney transplant patients, say researchers who analyzed data on about 20,000 Medicare patients who had kidney transplants between 1995 and 2003. None of the patients had diabetes before their kidney transplant. Compared to other anti-rejection drugs, sirolimus was associated with a 36 percent to 66 percent increased risk of diabetes after transplant.
Sirolimus
New-onset diabetes (NOD) is associated with transplant failure. A few single-center studies have suggested that sirolimus is associated with NOD, but this is not well established. With the use of data from the United States Renal Data System, this study evaluated the association between sirolimus use at the time of transplantation and NOD among 20,124 adult recipients of a first kidney transplant without diabetes.
Sirolimus
Reduces Polycystic Liver Volume in ADPKD Patients.
Immunosuppression induced diabetes
129 consecutive renal transplants done at St George's Hospital since 1995, with 1-year follow-up, treated with tacrolimus and prednisolone with the addition of azathioprine or mycophenolate mofetil in some cases. Our standard steroid dosing regimen is 500 mg methylprednisolone at the time of surgery, then 20 mg prednisolone per day, reducing by 5 mg every 2 weeks to a maintenance dose of 5 mg daily. Target tacrolimus whole blood 12 h post-dose (trough) concentrations were 15—20 ng/ml for the first week, 10—15 ng/ml for the first 3months, then 8—10 ng/ml until the end of the first year.
Reversal of corticosteroid-induced diabetes mellitus with supplemental chromium
A. Ravina*, L. Slezak*, N. Mirsky*, N. A. Bryden and R. A. Anderson
*Department of Diabetes, The Linn Clinic, Haifa, Department of, Biology, Oranim University of Haifa,
Israel Nutrient Requirements and Functions Laboratory, Beltsville Human Nutrition Research Center,
Beltsville, MD, USA
Correspondence to: Dr Richard A. Anderson, USDA, ARS, BHNRC, NRFL, Bldg. 307, Rm. 224, BARC-East,
Beltsville, MD 20705—2350, USA.
Conclusions: These data demonstrate that corticosteroid treatment increases chromium losses and that
steroid-induced diabetes can be reversed by chromium supplementation. Follow-up, double-blind studies are
needed to confirm these observations.
Diabet. Med. 16, 164—167 (1999) This is an older article. Perhaps there are new current treatments
available. A friend with PKD and PLD got severe diabetes from transplant medications. Eventually she
needed a second transplant.
New Kidney Function Tied to Vitamin D Status
Low vitamin D after a kidney transplant is associated with worse kidney function and increased fibrosis, researchers reported.
