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Glucose-lowering agents for treating pre-existing and new-onset diabetes in kidney transplant recipients.

ABSTRACT:

SUBMITTER: Lo C

PROVIDER: S-EPMC8477618 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Glucose-lowering agents for treating pre-existing and new-onset diabetes in kidney transplant recipients.

Lo Clement C Toyama Tadashi T Oshima Megumi M Jun Min M Chin Ken L KL Hawley Carmel M CM Zoungas Sophia S

The Cochrane database of systematic reviews 20200730

<h4>Background</h4>Kidney transplantation is the preferred management for patients with end-stage kidney disease (ESKD). However, it is often complicated by worsening or new-onset diabetes. The safety and efficacy of glucose-lowering agents after kidney transplantation is largely unknown. This is an update of a review first published in 2017.<h4>Objectives</h4>To evaluate the efficacy and safety of glucose-lowering agents for treating pre-existing and new onset diabetes in people who have underg ...[more]

PMID: 32803882

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Project description:The escalating amount of kidney transplant recipients (KTRs) represents a significant dilemma for primary care providers. As the number of physician assistants (PAs) has been steadily increasing in primary care in the United States, the utilization of these healthcare professionals presents a solution for the care of post-kidney transplant recipients. A physician assistant (PA) is a state licensed healthcare professional who practices medicine under physician supervision and can alleviate some of the increasing demands for primary patient care. Here we provide an outline of the crucial components and considerations for PAs caring for kidney transplant recipients. These include renal function and routine screenings, drug monitoring (both immunosuppressive and therapeutic), pre-existing and co-existing conditions, immunizations, nutrition, physical activity, infection, cancer, and the patient's emotional well-being. PAs should routinely monitor renal function and blood chemistry of KTRs. Drug monitoring of KTRs is a crucial responsibility of the PA because of the possible side-effects and potential drug-drug interactions. Therefore, PAs should obtain a careful and detailed patient history from KTRs. PAs should be aware of pre- and co-existing conditions of KTRs as this impacts treatment decisions. Regarding immunization, PAs should avoid administering vaccines containing live or attenuated viruses to KTRs. Because obesity following kidney transplantation is associated with decreased allograft survival, PAs should encourage KTRs to maintain a balanced diet with limited sugar. In addition, KTRs should be urged to gradually increase their levels of physical activity over subsequent years following surgery. PAs should be aware that immunosuppressive medications diminish immune defenses and make KTRs more susceptible to bacterial, viral, and fungal infections. Moreover, KTRs should be screened routinely for cancer due to the higher risk of development from immunosuppressive therapy. PAs must remain cognizant of the emotional well-being of the KTR, as many transplant patients struggle with fear, frustration, and acceptance.

Dataset Information

Glucose-lowering agents for treating pre-existing and new-onset diabetes in kidney transplant recipients.

Publications

Glucose-lowering agents for treating pre-existing and new-onset diabetes in kidney transplant recipients.

Similar Datasets

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