RECURRING AFFECTIONS IN KIDNEY`S POST-SURGICAL TRANSPLANTATION AND ITS IMPACTS: AN INTEGRATIVE REVIEW
ABSTRACT:
Chronic kidney disease affects approximately 12% of individuals worldwide, being recognized as a disorder in which the progressive loss of kidney functions occurs and, therefore, demands a replacement therapy for these activities. Moreover, kidney transplantation in most cases presents itself as the best treatment, as it guarantees an improvement in the patient's quality of life and in the survival rate. However, the effectiveness of this propaedeutic depends on the acceptance of the recipient to the transplanted organ, thus, the administration of immunosuppressants in continuous use is applied in order to control the immune response, avoiding rejection and the appearance of inflammatory diseases. However, this pharmacological class triggers changes that culminate in unwanted effects. Thus, the objective is to elucidate the main complications after renal replacement surgery and its impacts on patients' experiences. As this is an integrative literature review, the selection of articles on the VHL, PubMed and Google Scholar platforms was used as methodology with the keywords: Complications; Side effects; Immunosuppressants; Infections and Kidney Transplantation. The selection criteria were articles published between 2010-2020 in Portuguese, English or Spanish and complete, resulting in the selection of 20 articles in total. That said, the literature reports that, although essential for post-surgical success, immunosuppressive therapy has several negative repercussions in the short and long term. In the initial six months, it was found that over 50% of the operated patients had bacterial infections, caused by Cytomegalovirus and multidrug-resistant microorganisms. In the following period, the tendency was the appearance of opportunistic, viral and fungal infections, with candidiasis and mucormycosis prevailing in the latter, with an evolution to death in 68.2% and 54.4%, respectively. In addition, it was found that over 60% of individuals became hypertensive, and consequently, more susceptible to diabetes. Furthermore, the mortality rate due to cardiovascular diseases was 50% higher when compared to the general population. At the same time, other comorbidities such as obesity, dyslipidemia, anemia, neoplasms, as well as skin changes such as acne, warts, hyperplasia of sebaceous glands can affect the transplanted individual. Therefore, it is concluded that kidney transplantation fulfills the role of supplying the lack of renal functions in patients with terminal illness. However, the immunosuppressants used in the post-surgical period to prevent rejection of the new organ, unfortunately, weaken the transplant recipients' immune system and make them susceptible to various opportunistic infections. Thus, it is necessary to carry out more scientific studies in the area in order to provide an improvement in the quality of life of transplanted individuals, in addition to providing greater clarification to health professionals on the proper management of these patients.
KEYWORDS: Complications. Immunosuppressants. Infections. Kidney transplantation. Side effects.
