Liver Transplant and Kidney Function
What are kidneys and what do they do?
There are two kidneys in our bodies. They are bean shaped organs about the size of the fist. One
lies on each side of the spine just below the rib cage. The kidneys:
ξ Make sure the body has the right amount of water, minerals, and acids.
ξ Remove waste products from the body through urine.
ξ Help make red blood cells.
ξ Help to control blood pressure.
ξ Release hormones to keep bones strong.
ξ House the adrenal glands which sit on top of the kidneys. These glands serve an
important role with hormones, especially the production of natural steroids and
hormones needed for fluid and salt balance in the body.
What causes kidneys not to work?
There are many things that can cause the kidneys not to work well.
ξ Age – as we get older, kidney function declines
ξ Chronic diseases such as diabetes and high blood pressure damage the kidneys
ξ Diseases that cause failure in other organs, such as the heart or liver can hurt the kidneys
ξ Dehydration or poor blood flow
ξ Kidney stones
ξ Urinary tract infections
ξ Medicines or drugs-The medication you take to prevent your body from rejecting your
new organ can be hard on the kidneys. We need to monitor your blood work closely to
make sure you are not getting too much of this medicine. Also, some pain medicine like
ibuprofen (Advil) and aspirin are hard on the kidneys.
Can I tell if my kidneys are damaged?
You will often not have signs or symptoms of kidney damage until the damage is severe. Your
transplant team and other doctors can detect kidney damage through blood and urine tests. The
blood test used to check for kidney damage is creatinine. We will also check a urine specimen at
clinic visits for early detection of changes in your kidney function.
When the kidneys aren’t working well waste products build up in your body and make you feel
sick. You can get swelling in your arms and legs (edema). You may not be able to make enough
red blood cells, causing you to become anemic. You may develop high blood pressure. Your
bones may become weak.
Can kidney damage be treated?
Yes! This most often involves treating the cause of the kidney damage. For example, doctors
can treat kidney stones and urinary tract infections to help prevent them from causing serious or
permanent kidney damage. Using medicines to control blood pressures and keep blood sugars in
normal ranges can greatly impact long-term kidney function. If medicines are causing kidney
damage doctors can often switch to different medicines or lower doses to protect the kidneys.
When the kidneys become permanently damaged, patients need dialysis or kidney transplant to
restore the functions of the kidneys.
Are there things I can do to prevent kidney damage?
Yes! There are many things you can do to help prevent kidney damage:
ξ Have blood and urine tests done on a routine basis: This will help your transplant
team and other doctors check for kidney damage early so they can treat it.
ξ Avoid dehydration: Good fluid intake is important. Remember, fluids that have
caffeine or alcohol will dehydrate you more! If you are losing a lot of fluid through
nausea, vomiting, or diarrhea, notify your transplant team. You may need to get
fluids through an IV to prevent dehydration. You should drink at least 8 glasses of
water each day and more if you exercise or if it is hot outside.
ξ Check your blood pressure daily and tell your transplant team and your local doctors
if it is high (a goal blood pressure is less than 130 on top and less than 80 on the
bottom). High blood pressure (over 130/80) can cause kidney damage.
ξ If you are diabetic, check your blood sugars regularly. Notify your local doctors and
your transplant team if your blood sugars are not in the goal range (70 to 150).
ξ Avoid medicines that are toxic to the kidneys such as ibuprofen (Advil®) and,
ξ Stop smoking.
ξ Tell your transplant team about any medicines, including those over-the-counter and
those prescribed by other doctors, that you are taking. Some of these medicines may
cause kidney damage and you may need to avoid them.
ξ See your transplant team and other doctors regularly. These routine visits allow your
doctors to watch for signs of kidney damage and review medicines you are taking that
may be causing kidney damage. Over time, they may be able to decrease doses of the
medicines that are used to prevent rejection that may cause kidney damage.
Having an organ transplant is a lifelong commitment. Along with keeping your new organ
working, patients must take steps to avoid damage to other organs in their bodies, such as their
kidneys. Members of your transplant team are available to assist with keeping you healthy and
help you maintain a normal, active life.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 3/2016. University of Wisconsin Hospital
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6793.