Kidney Matters - Issue 9 Summer 2020

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17
the first week of the transplant) resulted in significantly
increased rates of acute rejection, but had no effects
on the survival of the kidney or the recipient, at least
in the short term. The Renal Association advises that
if prednisolone is not withdrawn within the first month
after transplant, it should be maintained at a low dose
of 5mg a day or less.
“We aim for the balance
of immunosuppression
that is right for you”
Maria says: “We know that different transplant
units use different combinations of anti-rejection
medicines and get very good results. These drug
combinations are not exactly the same but are
similar and no one has the ‘best immunosuppression
cocktail’. But even if we did have it, we would still need
to be flexible if you or your kidney transplant did not
get on with those drugs.
“We aim for the balance of immunosuppression that
is right for you. No one wants you to have a perfectly
working kidney transplant and be struggling with side
effects. Ultimately, it is your body and it’s best when
you are involved in making decisions about your
health. As a renal pharmacist, my job is to work with
you. I tell my patients that if you need to make any
changes to your drugs, we are going to do it together
with a clear understanding of why we are making
changes and after considering the potential benefits
and risks.
“Prednisolone is neither a hero nor a villain. It’s more
complicated than that. Perhaps prednisolone is more
like an antihero: we know it can have side effects, but
it remains key to transplant success for most kidney
patients,” she concludes.
Article by Sue Lyon:
Freelance Medical Writer &
Editor, London
Kidney Care UK information
leaflet about medicines taken
after a transplant: https://www.
kidneycareuk.org/about-kidneyhealth/order-or-downloadbooklets/
General information on
prednisolone from the NHS:
https://www.nhs.uk/medicines/
prednisolone/
Renal Association guidelines
on post-operative care in the
kidney transplant recipient:
https://bit.ly/3cmA8bV
A Cochrane Library analysis
of studies of avoiding or
withdrawing steroids after
kidney transplant: https://bit.
ly/39dnGJB