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Managing Medication Adverse Effects Post Kidney Transplant

Archana Goel, MD
Cathy M. Ashbaugh, APRN

Introduction

Joan is a 61-year-old white female with end stage renal disease secondary to polycystic kidney disease. Her first kidney transplant was in 1985, which was cadaveric renal transplant (CRT). She developed chronic allograft nephropathy and lost her transplant after nearly 20 years and was restarted on hemodialysis in 2003. She received her second kidney transplant on 4/26/05, which was also a CRT. It was a 0 antigen match. She received immunosuppression prior to and after the transplant as per protocol.

Objectives

• A large part of post transplant care involves balancing the the use of immunosuppressive medications and preventing and treating complications of immunosuppressive therapy.
• Drug-related problems can result in hospitalization, morbidity and mortality.
• To prevent adverse drug interaction an alternative therapy is considered when possible, or the dose or schedule of the drugs should be adjusted to reduce the occurrence of an adverse effect.
• Careful monitoring to prevent and detect adverse effects is an essential part of patient care.