Underlining that the patient's compliance with treatment is very important after kidney transplantation, which is the best treatment option for end-stage renal failure in recent times, Nephrology Specialist Assoc. Prof. Dr. Ali Balkan said, “here may be a risk of kidney rejection in patients who do not use their medications properly.”

Kidney transplantation is the best treatment option in terms of both life expectancy and quality of life for patients with end-stage renal failure, whose number reaches 60 thousand in our country today. Reminding that, according to statistics, approximately 3500 kidney transplant operations are performed in our country every year, Yeditepe University Koşuyolu Hospital Nephrology Specialist Assoc. Prof. Dr. Ali Balkan pointed out that patient compliance is very important in order to achieve the desired result after transplantation.

Patients Must Follow The Rules!

Underlining that kidney transplant treatment is a lifelong process, including pre- and post-operative periods, Yeditepe University Koşuyolu Hospital Nephrology Specialist Assoc. Prof. Dr. Ali Balkan drew attention to the importance of the patient, who was at the center of the treatment in this process, to comply with the rules.

Factors Affecting Success After Kidney Transplantation

Stating that the fact that kidney function is in the range of 90-95 percent in the one year after kidney transplantation is an indicator that the transplant was successful, Assoc. Prof. Dr. Ali Balkan said, "This figure is in the range of 70-80 percent for 5 years." Underlining that many factors, from the patient's condition to the experience of the nephrologist and surgical team, are effective in the success of kidney transplantation, Assoc. Prof. Dr. Ali Balkan continued his words as follows: “For example, in the disease, we define as Focal segmental glomerulonephritis, which leads to very rapid kidney failure, the disease can recur even if the patient has a kidney transplant. Therefore, it is absolutely necessary to make a definitive diagnosis of the underlying disease. And a strategy should be formed accordingly. In addition, the experience of the transplant team, who plans the transplantation from the scheduling to the surgery and the next treatment process, is also very important.”

Medicines Should Be Used Correctly to Prevent Organ Rejection!

Reminding that 5-10 percent of kidney transplant patients experience organ rejection for different reasons in the first year, Assoc. Prof. Dr. Ali Balkan said; " As the immune system may reject the organ, factors such as the patient's use of medication or diet after transplantation may also affect this result. For this reason, one of the most important issues that patients should pay attention to after transplantation is regular physician check-ups and regular use of their medications. There is a risk of kidney rejection in patients who do not use their medications properly. We would like to see our patients in the first year, every month, and then every 3 months thereafter. Medicines must be used for life.”

Patients Should Be Psychologically Evaluated Before the Transplant

Reminding that most of the patients are careful about compliance with the drug, however, sometimes there may be deviations because it is a long-term treatment, Assoc. Prof. Dr. Ali Balkan said, “In this long-term treatment, sometimes the psychology of the patients may deteriorate, and some fluctuations may occur. In this case, the first thing they do is quit their medication. Sometimes, patients may stop taking the drug by saying that “I am completely healed.”. For this reason, patients need to undergo a general psychological evaluation for their compliance with treatment before transplantation. Because regardless of the reason, quitting the medication can increase the risk of organ rejection. Since the effects of these drugs can sometimes last for a couple of days, of course, skipping a dose for 1-2 days does not pose such a big risk. (Ama risk doğurmayacağı anlamına da  gelmesi  ilaçlarını  çok  düzenli kullanmaları  gereklidir orijinal metinde ne demek istediğini anlamadığım için çeviremedim) but they still need to take their medication very regularly. However, if drugs are neglected for a longer period, there is a much greater risk of organ rejection.”

Weight Control Should Be Ensured

Stating that another important point to be considered after kidney transplantation is the treatment of other diseases of the patient, Assoc. Prof. Dr. Ali Balkan spoke that, "For example, if the blood sugar control of a patient who develops kidney failure due to diabetes cannot be achieved, the transplanted kidney may also be affected. The same is true for patients with hypertension. Therefore, it is very important for the patients to get their life in order, eat regularly, pay attention to water consumption, and remove salt from their lives after kidney transplantation.”

Explaining that the patient's weight control is also very important in the period after kidney transplantation Assoc. Prof. Dr. Ali Balkan said, “Obesity is an inflammatory process and it affects the vessels throughout the body and causes inflammation. Since there is a vascular bundle in the kidney, obesity can also cause kidney deterioration. Therefore, we do not want the patients to gain weight, and if they have gained weight, we make them lose weight.”

Cadaveric Donation Rates Should Be Increased

Reminding that there are around 60,000 patients undergoing dialysis in Turkey and that approximately 3500 transplants can be made out of this population per year, Yeditepe University Koşuyolu Hospital Nephrology Specialist Assoc. Prof. Dr. Ali Balkan, ‘It should not be forgotten that many problems can be solved by increasing the cadaveric donation rates. Compared to hemodialysis, kidney transplantation is a much more convenient solution method in terms of both medical, social, and economic aspects. While only 10% of transplants in Turkey are made from cadavers, this rate is the opposite in the world. Therefore, it is necessary to increase organ donation in every layer of society.

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