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为肾移植受者提供护理:全科医生概述

Providing care for kidney transplant recipients: An overview for generalists.

作者信息

Belal Amer A, Santos Alfonso H, Kazory Amir, Koratala Abhilash

机构信息

Department of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL 32610, United States.

Department of Nephrology, Medical College of Wisconsin, Milwaukee, WI 53226, United States.

出版信息

World J Nephrol. 2025 Mar 25;14(1):99555. doi: 10.5527/wjn.v14.i1.99555.

Abstract

Kidney transplantation is the preferred treatment for patients with advanced chronic kidney disease and end-stage kidney disease, offering superior quality of life and survival compared to dialysis. This manuscript provides an updated overview of post-transplant care, highlighting recent advancements and current practices to assist generalists in managing these patients. It covers key areas such as immunosuppression strategies, drug interactions, and the management of transplant-specific acute kidney injury. The focus includes the use of sodium-glucose cotransporter-2 inhibitors and cell-free DNA monitoring for evaluating allograft health and immune-mediated injury. The manuscript reviews the fundamentals of immunosuppression, including both induction and maintenance therapies, and underscores the importance of monitoring kidney function, as well as addressing hypertension, diabetes, and infections. It also provides recommendations for vaccinations and cancer screening tailored to kidney transplant recipients and emphasizes lifestyle management strategies, such as exercise and sodium intake, to reduce post-transplant complications.

摘要

肾移植是晚期慢性肾病和终末期肾病患者的首选治疗方法,与透析相比,可提供更高的生活质量和生存率。本手稿提供了移植后护理的最新概述,重点介绍了近期进展和当前实践,以帮助全科医生管理这些患者。它涵盖了免疫抑制策略、药物相互作用以及移植特异性急性肾损伤的管理等关键领域。重点包括使用钠-葡萄糖协同转运蛋白-2抑制剂和无细胞DNA监测来评估移植肾健康和免疫介导的损伤。该手稿回顾了免疫抑制的基本原理,包括诱导和维持治疗,并强调了监测肾功能以及处理高血压、糖尿病和感染的重要性。它还针对肾移植受者提供了疫苗接种和癌症筛查的建议,并强调了生活方式管理策略,如运动和钠摄入,以减少移植后并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2baf/11755230/f33ff31f8a0d/99555-g001.jpg

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