| [ Summary ] |
The main goal for long term management after kidney transplantation is to maximize the longevity of the allograft and prevent premature mortality of the patient. The Kidney Disease Outcomes Quality Initiative (K / DOQI) and the Kidney Disease : Improving Global Outcomes (KDIGO) outline can be utilized as guides in developing clinical plans for kidney transplant recipients. All recipients should be considered to have chronic kidney disease (CKD) because of the toxicity of immunosuppressive agents and pathologic damage, due to immunological or non immunological causes. Decreased allograft functioning is associated with many complications, such as cardiovascular disease (CVD), anemia, malnutrition, abnormal bone metabolism or opportunistic infection, and the need for life-long care caused by complications. Recipients who progress to advanced stages of CKD have an especially high risk of CVD and infection. Therefore, allograft functions continue to deteriorate, despite all treatments to prepare them for a return to dialysis. Immunosuppressants should be withdrawn in a step by step fashion, at the initiation of dialysis, to avoid life threatening complications. |