Kidney transplant during the COVID pandemic – FAQs

Category: Nephrology & Dialysis October 14, 2020 Author: Dr. Mohit Khirbat

Kidneys are two bean-shaped organs, which are responsible for filtering out toxins and waste fluids from our blood. This waste is then excreted from our body in the form of urine. They are present on either side of the spine, right below the rib cage.

In some situations, the kidneys may lose their filtering ability. When they lose more than 90% of their functional ability, they are considered to be in end-stage kidney disease (renal/kidney failure). In such cases, the patient would have to undergo routine dialysis to artificially filter their blood, or get a kidney transplant. In this article, we will look closer at the causes of kidney failure, caring for a kidney transplant and what all to keep in mind when considering kidney transplants during the COVID-19 pandemic.

Table of Contents

What causes kidney failure?

Kidney failure can occur due to a number of reasons. Underlying health conditions which damage the kidneys over a period of time is one of the most common causes of kidney failure. Diabetes, uncontrolled high blood pressure, autoimmune diseases, genetic conditions, urinary tract problems, nephrotic syndrome are some such conditions which can damage your kidneys over time. If these conditions are not kept in check, they continue to damage the kidneys, and the patient is said to have chronic kidney disease (CKD).

In some cases, the kidneys can suddenly stop working. This is called Acute Kidney Injury (AKI) or Acute Kidney Disease (AKD). This can be the result of any trauma, heart attack, drug abuse, lack of blood supply to the kidneys and urinary tract problems. This may or may not be permanent.

Read: Chronic Kidney disease: What is it and how can it be prevented?

How do you know if you have kidney failure?

Some of the most common symptoms of kidney failure are

Nausea
Sleep disorders
Loss of appetite
Fatigue
Weakness
Unusual weight loss
Itching
Muscle cramps
Swelling in the feet or ankles (oedema)

What do you do if you have kidney failure?

Fortunately, patients with kidney failure can still lead completely normal lives with routine dialysis or a kidney transplant.

Dialysis is a process to artificially filter the blood of waste and toxins. There are two types of dialysis: Haemodialysis and Peritoneal dialysis. Based on the type of dialysis you are recommended, you would have to undergo this treatment daily (peritoneal dialysis) or 3-4 times a week (haemodialysis).

Kidney transplant on the other hand, offers a more permanent solution to kidney failure. Kidney transplant is a surgical procedure in which one or two healthy kidneys are placed inside your body when your own kidneys are no longer functioning properly. The damaged kidneys may or may not be removed.

How do you decide between dialysis and kidney transplant?

There are many factors to consider before deciding between kidney transplants and dialysis. These include your age, general health, lifestyle, pre-existing conditions and availability of a donor kidney. Another major thing to consider is that kidney damage may not be permanent. Your doctor will take all these factors into consideration while discussing all viable treatment options with you.

What are the benefits of a kidney transplant?

In many cases, where the kidney damage is irreversible, patients would require dialysis for the rest of their life. Kidney transplant can be a more permanent solution. Research indicates that kidney transplant is associated with a better quality of life, lower risk of death, fewer dietary restrictions and ultimately lower treatment cost (in the long run). Some people may also choose to opt for a kidney transplant before they require dialysis. This process is called a preemptive kidney transplant.

Kidney transplant is not suitable for everyone. Your doctor might rule out kidney transplant in the following cases:

If the patient is of advanced age
If the patient has severe heart disease
If the patient has or was recently treated for cancer
If the patient has any mental illness, including dementia
If the patient is an addict or alcoholic
If there are any other factors that can create complications during or after the procedure

What are the risks of a kidney transplant?

Apart from the risks associated with any form of surgery such as infection, excessive bleeding, complications from general anaesthesia, etc, there is also a risk of rejection of the donor organ and side-effects of the anti-rejection medication that can occur with kidney transplant. Talk to your doctor in detail about all these risks before opting for a kidney transplant.

What can you expect after a kidney transplant?

After the procedure is completed, you would be required to stay in the hospital under observation for several days up to a week, based on how the procedure went as well as your recovery rate. During this time, your healthcare providers would monitor you closely to ensure that you are recovering fine. In some cases, you may also require dialysis till the time your new kidneys start functioning satisfactorily. You would be advised to avoid all unnecessary physical exertion till your surgical wounds have healed completely.

After you are discharged from the hospital, you would be asked to come for routine checkups. This is just to make sure that your new kidneys are functioning right and your body is not rejecting the donor kidney(s). You would also be required to take several medications which are designed to stop your immune system from attacking your new kidneys. These medicines are called immunosuppressants.

What diet should you follow after a kidney transplant?

Diet plays an important role in determining the success of your kidney transplant. It is essential to maintain healthy body weight and follow a balanced diet. The major points to keep in mind while choosing what to eat is to avoid excess salt, limit your fat intake and consume more fibre rich food. Ideally, you should have fresh fruits, vegetables, lean meat, low-fat dairy products, whole grains and lots of water. Apart from this, your doctor and/or dietician would give you a more personalised diet plan that would be best suited for you.

Does a kidney transplant increase the risk of COVID-19?

Because of the ongoing global pandemic, “Does transplant increase the risk of COVID-19” is one of the most common questions asked today. Due to the anti-rejection medications which are required after the transplant, there is a higher risk of any infection, including COVID-19. Hence, it is that much more essential that you follow the precautions laid out by healthcare advisories regarding COVID-19. This includes:

Wash your hands regularly and thoroughly with soap and water or alcohol-based sanitizers
Avoid touching your nose, eyes or mouth with un-sanitised hands
Maintain at least 6 feet distance from anyone with any respiratory symptoms such as sneezing, coughing, wheezing etc
Stay at home if you have any flu like symptoms such as fever, cough, sore throat, headache or body aches
Cover your face everytime you sneeze or cough with disposable tissues or the sleeve of your elbow (avoid using hands)
Disinfect any surfaces that you touch frequently

While these are general precautionary guidelines against COVID-19, these are especially important for people who are at a higher risk, including people who are immunocompromised, have had any type of surgery recently and any type of transplant patient.

Any individual living with a transplant patient, will need to be more cautious, limit their exposure, avoid crowds and strictly follow social distancing whenever they step outside. They will have to be diligent about their sanitisation and should never interact with the transplant patient without taking the necessary precautions. For further information regarding kidney disease and kidney transplant, you can speak to our nephrology team.