Which immunization should the nurse teach the parents about that will help decrease the incidence of hepatic disease later in life?
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IntroductionThe long term success of a kidney transplant depends on many things. You should:
Big victories are possible with your voice.Become an NKF advocate. Rejection and transplant medicineRejection is the most common and important complication that may occur after receiving a transplant. Since you were not born with your transplanted kidney, your body will think this new tissue is “foreign” and will try to protect you by “attacking” it. Rejection is a normal response from your body after any transplant surgery. You must take anti-rejection medicine exactly as prescribed to prevent rejection. Are there different types of rejection? There are two common types of rejection:
What are anti-rejection medications? Anti–rejection (immunosuppressant) medications decrease the body’s natural immune response to a “foreign” substance (your transplanted kidney). They lower (suppress) your immune system and prevent your body from rejecting your new kidney. Why do I need to take anti-rejection medication? Kidney rejection is hard to diagnose in its early stages. Rejection is often not reversible once it starts. You should never stop taking your anti-rejection medication no matter how good you feel and even if you think your transplanted kidney is working well. Stopping or missing them may cause a rejection to occur. How should I take anti-rejection medication? Here are some tips to help you take your anti-rejection (immunosuppressant) medication as directed:
Do anti-rejection medications have side-effects? Anti-rejection (immunosuppressant) medications have a number of possible side-effects which are usually manageable for most patients. Blood levels of anti-rejection medications will be checked regularly to prevent rejection and lessen side-effects. If side-effects do occur, your doctor may change the dose or type of medications. What are the side-effects of anti-rejection medications? Some of the most common side-effects of anti-rejection (immunosuppressant) medications include high blood pressure, and weight gain, an increased chance of having infections, and increased risk of some forms of cancer. What are the types of anti-rejection medications? There are 3 groups of anti-rejection (immunosuppressant) medications:
Back To Top ↑ Infection Why is infection a concern after kidney transplant? The anti-rejection medicines that help keep your body from rejecting your transplanted kidney also lower your immune system. Because your immune system is lowered, viral and other infections can be a problem. What is the best way to stay healthy? Finding and treating infections as early as possible is the best way to keep you and your transplanted kidney healthy. Exposure to diseases such as the flu or pneumonia can make you very sick. Receiving vaccines as determined by your transplant team can help you stay healthy. It is also important to frequently wash your hands or use an antimicrobial gel during cold and flu season. What problems should I report to my doctor? You should report any of the following problems to your doctor as soon as possible:
How can I avoid getting infections? To avoid getting infections you should:
Back To Top ↑ Vaccines Can a vaccine be harmful after kidney transplant? Vaccines help your body protect you from infection. Some vaccines are not good for you when you have a transplant. For example, you should avoid all “live vaccines.” Check with your transplant team before receiving any vaccines or boosters. What are some general rules for getting vaccines such as Hepatitis B, live vaccines, or a flu shot? You should:
What if someone I know receives a live vaccine? You should avoid direct contact with anyone who has received a live vaccine. Examples include:
What if I travel to another country? Contact your transplant physician if you plan to travel to another country. You may need to receive certain vaccines to prevent diseases that are common to the area. Which vaccines are safe to get? Always talk to your transplant coordinator before getting any vaccines or boosters. The following vaccines are recommended:
Which vaccines should I avoid? You should NOT receive the following “live” vaccines:
Back To Top ↑ New-onset diabetes after transplantWhat is new-onset diabetes after transplant or NODAT? Even if you did not have diabetes before, you may develop diabetes after transplant. This type of diabetes is called new-onset diabetes after transplant or NODAT. This can occur as a side effect of the medications that you need to prevent rejection of your new kidney. What are my chances of having new-onset diabetes after transplant? Your chances of having new-onset diabetes after transplant will be higher if you are obese. Your chances are also increased if others in your family have diabetes. Why should I worry about diabetes? Having a high blood sugar level due to diabetes or due to NODAT can cause serious damage to your heart, blood vessels, eyes, feet, and nerves. How can I find out about my blood sugar? Blood sugar levels will be closely watched while you are in the hospital after the transplant and in the outpatient clinic. If needed, your doctors will help you develop a plan to keep your blood sugar under control. If you are on corticosteroid medication (such as prednisone), your blood sugar levels will improve as the dose of this medication is decreased in the first 2 months after transplant. If I have diabetes, how can I control my blood sugar? Your transplant team will help you manage your blood sugar. High blood sugar is usually done with:
Back To Top ↑ Heart diseaseWhat are my chances of getting heart disease after a kidney transplant? People with kidney transplants are at greater risk for heart disease. There are many causes for heart disease including: smoking, diabetes, overweight, hypertension, high cholesterol and blood lipids, and number of years on dialysis. How can I lower my chances of getting heart disease? Here are some important things for you to do now to lower your chances for getting heart disease later (see information on each topic):
Back To Top ↑ High blood pressureWhat are my chances of having high blood pressure after a kidney transplant? If you had high blood pressure before getting your new kidney, it may continue after your transplant. High blood pressure might also occur as a side-effect of anti-rejection medications, organ rejection and/or obesity (from weight gain after transplant). Should I check my blood pressure? You should check your blood pressure as directed by your transplant team. The target blood pressure for people with a kidney transplant is less than 130/80. How can I control my blood pressure? Your doctor will help you manage your blood pressure. High blood pressure is usually controlled with:
Back To Top ↑ High cholesterol and blood lipidsWhat are my chances of having high cholesterol and blood lipids after kidney transplant? Many people may have higher cholesterol and lipid levels in the blood after transplant due to medication side-effects , weight gain, poor diet, family history, or lack of exercise. Kidney-related issues that cause protein in the urine (proteinuria) can also increase blood lipids. Why should I worry about high cholesterol and blood lipids? High blood lipids can lead to clogged blood vessels. When this occurs it increases risk of heart disease and stroke. How can I control my cholesterol and blood lipids? Your doctor will help you manage your cholesterol and blood lipids. Controlling high cholesterol and blood lipids is usually done with:
Back To Top ↑ Stop smokingWhy should I stop smoking? Smoking cigarettes significantly increases your risk for heart disease, cancer and lung disease. It may also decrease the amount of time your new kidney will work. How can I get help to stop smoking? Ask your doctor about medication to help you quit smoking if you are having a problem quitting on your own. Also ask your transplant team about programs in your area. There are also online programs and Apps you may want to try. Here are some examples:
Back To Top ↑ Healthy weightWhat are my chances of gaining weight after kidney transplant? It is very likely that you will gain weight after your kidney transplant. Weight gain after transplant is common due to medication side-effects and a less strict diet (as compared to the diet for dialysis). Why should I worry about gaining too much weight? Gaining too much weight can lead to having too much total body fat. This is known as obesity. Obesity increases the risk of heart disease and new-onset diabetes after transplant (NODAT). How can I keep a healthy weight? Your transplant team will include a dietitian. Your doctor and dietitian will help you develop a plan to keep a healthy weight. To control weight, work with your dietitian to reduce calories. Also, you should exercise regularly as allowed by your doctor If I have Medicare, can I ask my doctor for a Medical Nutrition Therapy referral to see a registered dietitian? Medicare covers Medical Nutrition Therapy services prescribed by a doctor for patients with diabetes or chronic kidney disease, and includes transplant patients. The services provided by a registered dietitian include:
Back To Top ↑ Bone diseaseWhat are my chances of having bone disease after kidney transplant? Bone disease (also known as chronic kidney disease-mineral and bone disorder or CKD-MBD) may continue even after your kidney transplant. CKD-MBD occurs due to medication side-effects, previous kidney disease, diabetes, smoking, lack of exercise, menopause, or number of years on dialysis. Why should I care about bone disease? Bone disease can cause weak and brittle bones and increase your chance for fractures. How can I find out if I have bone disease? To check your bone health your doctor will test your blood levels of calcium, phosphorus, parathyroid hormone (PTH) and vitamin D. How can I lower my chances of having bone disease? Weight bearing exercise such as walking, biking and using weights is a good way to increase bone and muscle strength. If your blood level of vitamin D is low your doctor may prescribe a vitamin D supplement. Can I take bone density medications? Bone density medications are not commonly used after kidney transplant. If your doctor suggests this option a bone biopsy may be needed to check your bone health before starting this medication. Back To Top ↑ Anemia What are my chances of having anemia after a kidney transplant? Following a kidney transplant you may have anemia (low red blood cell count) due to the surgery, medication side-effects, infection, abnormal breakdown of red blood cells, or organ rejection. Blood pressure medication can cause your body to make fewer red blood cells. Why should I care about anemia? Mild anemia can cause minor problems like feeling tired and having pale skin. If left untreated, anemia can cause a lack of oxygen to organs and lead to serious health problems such as heart failure. What should I do if I have anemia? If you have anemia your doctor may prescribe an iron supplement or other medications. There are many choices for iron pills; if you do not tolerate one iron supplement, ask about other choices. Your doctor will work with you to decide on the best treatment. It is also important to eat a healthy diet. Back To Top ↑ Gout What is gout? Gout is a condition that occurs when high blood uric acid levels cause crystals to build up in the joints, causing painful swelling. What are my chances of having a high blood uric acid level (hyperuricemia) after kidney transplant? Your body may have a hard time getting rid of uric acid (a normal waste product in blood) after your kidney transplant. This is often due to side-effects from medications, such as cyclosporine, leading to a high uric acid level in blood. What do I do if I have high blood uric acid levels or gout? Your doctor will help you manage high blood uric acid levels or gout. This is usually done with:
Back To Top ↑ Sexual activity and fertilityWhat happens to sexual function after kidney transplant? Most sexual functions return after a successful transplant if the problem was due to kidney disease or dialysis. You and your spouse or significant other should talk to your transplant team about any problems with sexual function, or if you have questions about safe sex, contraception or pregnancy. If I am a woman of child bearing age, can I become pregnant after kidney transplant? Women of child bearing age should consult with their transplant physician regarding pregnancy and/or contraception. If you are thinking about becoming pregnant, talk to your transplant team. Before becoming pregnant you should:
Back To Top ↑ Mental healthWhat if I feel anxiety or depression after kidney transplant? Anxiety and depression are common following kidney transplant. You may even become overwhelmed because of all the new things and changes that are happening to you following your transplant. This is a normal feeling for some transplant recipients. What are the causes of depression and anxiety? Depression and anxiety may be due to prior health problems, sleep disorders, or stress from the transplant itself. For example, it is normal to worry about the health of the living donor or the tragedy the deceased donor’s family felt. Some anti-rejection medications may also cause depression or mood swings until the dose is decreased. What should I do if I feel anxiety or depression? Discuss these issues with your transplant team to determine if treatment is needed. They can plan the right treatment for you to help you through this period. Back To Top ↑ Healthy lifestyleWhy is a healthy lifestyle important after kidney transplant? A healthy lifestyle is important for many reasons. Many conditions such as new onset diabetes after transplant (NODAT), high cholesterol, and high blood pressure can be improved through living a healthy lifestyle. A healthy lifestyle also helps bring about a feeling of wellness. How do I follow a healthy lifestyle? Your transplant team will help you make the right choices to develop and live a healthy lifestyle. You should:
Back To Top ↑ Patient assistance programsWhat if I have Medicare and need help paying for my transplant medications? If you have Medicare and are having trouble paying for your prescriptions there is extra help available. You should apply for “Extra Help” with Medicare Prescription Drug Plan Costs through the Social Security Administration. Learn more and apply online. Or call Social Security at 1-800-772-1213 or visit your local social security office. Are there any other prescription assistance programs? Yes, here are some websites that allow you to search for prescription assistance programs by medicine: The Partnership for Prescription Assistance or call at 1-888-4PPA-NOW (1-888-477-2669) Helps qualifying patients without prescription drug coverage get the medicines they need for free or nearly free. Good search tool when looking for prescription assistance programs. RxAssist Patient Assistance Program Center RxAssist can help you learn about ways to use pharmaceutical company programs and other resources to help reduce your medication costs. Needy Meds This program helps people obtain prescription assistance and offers a discount card for those eligible. It can help people save up to 80% on the cost of their medications. Do drug companies offer prescription assistance programs? Yes, many drug companies offer prescription assistance programs for their medications to those who qualify. Click here to see some common medications and companies for kidney transplant. Do any states offer prescription assistance programs? Yes. Check with your transplant social worker to see if your state offers a prescription assistance program and to see if you qualify. How can I find out about other community resources and medication assistance programs? Call NKF Cares, sponsored by the National Kidney Foundation. This patient hot line offers help for people affected by kidney disease, or those with questions on organ donation or transplantation. Speak with a trained professional who will answer your questions and listen to your concerns. Call toll-free at 855.NKF.CARES (855.653.2273). Back To Top ↑ More informationDefinitionsAnemia – Low red blood cell count Attenuated – Weaker or lower strength Bone biopsy – Used to diagnose bone disease by taking a small sample of bone from the body and looking at it under a microscope CKD-MBD (Chronic kidney disease bone and mineral disorder) – Disease that affects the bones and blood vessels Corticosteroid – A type of medication used to treat inflammation Gout – A conditions that occurs when high blood uric acid levels cause crystals to build up in the joints, causing painful swelling GFR (Glomerular filtration rate) – A measure of kidney function Heart healthy diet – A diet low in fat, cholesterol and sodium Hepatitis B (HepB) – A disease that causes irritation and swelling of the liver Hyperuricemia – High uric acid level in blood Immunosuppressants – Medications to help prevent transplant rejection Lipids – A fatty substance than can build up in blood NODAT (New onset diabetes after transplant) – Diabetes that develops after a transplant NSAIDS (non-steroidal anti-inflammatory drugs – A type of medication used to treat inflammation and mild to moderate pains. NSAIDS are harmful because they reduce blood flow to your transplanted kidney. You should avoid NSAIDS Obesity – Having too much total body fat Obstetrician – A medical doctor who offers a variety of women's health services and specializes in the management of pregnancy, labor, and birth. Proteinuria – Protein in the urine UVA and UVB (Ultraviolet radiation) – Radiation from sunlight that can cause skin cancer Varicella zoster – Herpes virus that causes chicken pox and Herpes zoster (shingles) Back To Top ↑ If you would like more information, please contact us. Last Reviewed: 10/03/2021 What does HEP B vaccine prevent?Hepatitis B vaccine can prevent hepatitis B. Hepatitis B is a liver disease that can cause mild illness lasting a few weeks, or it can lead to a serious, lifelong illness.
Why do we vaccinate babies against HepB?Why should my baby get the hepatitis B shot? Protects your child from against hepatitis B, a potentially serious disease. Protects other people from the disease because children with hepatitis B usually don't have symptoms, but they may pass the disease to others without anyone knowing they were infected.
Why is rotavirus vaccine important?Since its introduction into the vaccination programme, the rotavirus vaccine has significantly reduced the number of children who have diarrhoea and vomiting, and reduced the number of severe rotavirus infections.
What is the Hep B vaccine called?In November 2017, a vaccine was approved by the FDA for use in the U.S. Heplisav-B (Dynavax) is a two-dose vaccine approved for use in adults aged 18 and older. The vaccine is administered as two doses given one-month apart.
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