Avtor/Urednik		Bren, Andrej
Naslov		Ambulantno vodenje bolnikov po presaditvi ledvic
Prevedeni naslov		Outpatient magement of kidney graft recipients
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 43, št. Suppl 1
Leto izdaje		2004
Obseg		str. 43-6
Jezik		slo
Abstrakt		Kidney graft recipients require frequent follow-ups at the transplantation center. Good co-operation between the attending family doctor's team and the nephrologist is essential. The patients should also be thoroughly informed about their condition. During the early post-transplant period, special attention should be focused on fever, elevation of serum creatinine values, graft tenderness, fluid retention, oliguria and medications. During the late post-transplant period, reduction of immunosuppression should be considered, a strategy for preventing non-compliance should be adopted, renal function should be closely monitored, graft biopsy should be performed early and often in order to detect late acute graft rejection, and hyperlipidemia and hypertension should be treated aggressively. The patient should be encouraged to stop smoking and screened for breast, cervical, prostate, colorectal and skin cancer, as well as immunized against influenza and pneumococcal pneumonia. Prophylaxis with aspirin, calcium and hormone-replacement therapy should also be considered.
Izvleček		Za bolnike s presajeno ledvico je nujna kontrola v transplantacijskem centru. Potrebno pa je doseči tudi dobro sodelovanje med zdravstvenimi delavci, ki skrbijo zanje, med družinskim zdravnikom in nefrologom. Bolniki morajo biti dobro poučeni o svoji bolezni. V zgodnjem obdobju po presaditvi ledvice moramo biti posebno pozorni na naslednje pojave: povišano telesno temperaturo, povečano koncentracijo serumskega kreatinina, občutljivost presadka, zadrževanje tekočin, oligurijo, pa tudi na doziranje zdravil. V kasnem obdobju po presaditvi pa je potrebno razmišljati o zmanjšanju imunosupresije, preprečevati nesodelovanje bolnika, skrbno slediti funkcijo presadka; ob sumu na akutno zavrnitev čimprej narediti biopsijo presadka, agresivno zdraviti hiperlipidemijo in hipertenzijo, bolnika spodbujati k opustitvi kajenja, načrtno slediti morebitne pojave karcinoma dojke, cerviksa, prostate, kolorektuma, kože; poleg tega bolnike imunizirati proti influenci in pnevmokokni pljučnici ter razmisliti o profilaksi z aspirinom, kalcijem in nadomestnimi hormoni.
Deskriptorji		KIDNEY TRANSPLANTATION AMBULATORY CARE POSTOPERATIVE CARE