General health management and long-term care of the renal transplant recipient

被引:40
作者
Cohen, D
Galbraith, C
机构
[1] Columbia Presbyterian Med Ctr, New York, NY 10032 USA
[2] Univ Calif San Francisco, Med Ctr, San Francisco, CA 94143 USA
关键词
renal transplantation; cardiovascular disease (CVD); hypertension; diabetes; hyperlipidemia; malignancy; pregnancy; bone disease; immunosuppression;
D O I
10.1053/ajkd.2001.28922
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
The steady improvement in short-term success rates in renal transplant patients has translated into better long-term success rates and a large number of patients with long-functioning renal transplants. The necessity for the lifelong administration of immunosuppressive medications to prevent rejection, coupled with the presence in many patients of a variety of other medical problems dating from the period of renal insufficiency prior to the time of renal transplantation, has created a large group of patients with a unique and complex set of long-term medical care needs. Due to the constraints of managed care, considerations of geography, or patient preference, the long-term care of an increasing number of renal transplant recipients has shifted away from the transplant center to the community-based nephrologist or Internist. For optimal care to be delivered, it is important that the physicians managing these patients be cognizant of the complex and interacting medical issues involved in their care. Appropriate management can significantly prolong the life of the allograft as well as that of the patient. Guidelines for understanding and managing some of the more important and common general medical problems facing the long-term renal transplant recipient (eg, infectious complications, cardiovascular disease, hypertension, diabetes, hyperlipidemia, malignancy, pregnancy, bone disease, dental care, preventive care) are addressed in this section. (C) 2001 by the National Kidney Foundation, Inc.
引用
收藏
页码:S10 / S24
页数:15
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