Symptoms and Signs of Kidney Transplant: End-Stage Renal Disease

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 9/24/2021

Doctor's Notes on Kidney Transplant: End-Stage Renal Disease

Kidney failure so advanced it cannot be reversed is called end-stage renal disease (ERSD). The kidneys in end-stage renal disease no longer function adequately to keep a person alive. End-stage renal disease cannot be treated with drugs. Dialysis and kidney transplantation are the only treatments for this condition.

Early stages of renal failure may not be present, or they may be very mild. Symptoms of kidney failure tend to occur when the condition has become severe or critical. Kidney failure itself is not painful, although there may be pain from damage to other systems. Symptoms of kidney failure include

  • fluid retention (this causes puffiness, swelling of arms and legs, and shortness of breath [due to fluid collection in the lungs, called pulmonary edema]),
  • dehydration,
  • urinating less than usual,
  • urinary frequency or urgency,
  • bleeding due to impaired clotting,
  • easy bruising,
  • fatigue,
  • confusion,
  • nausea,
  • vomiting,
  • loss of appetite; pain in the muscles,
  • joints,
  • flanks,
  • chest; bone pain or fractures,
  • itching, and
  • pale skin (from anemia).

What Is the Treatment for a Kidney Transplant?

After kidney transplant surgery, you probably will need to stay in the hospital several days to recover.  If there are complications you may have to stay longer.

While in the hospital you will be given anti-rejection drugs so your body does not reject the new kidney. You should never stop taking your anti-rejection medication no matter how good you feel and even if you think your transplanted kidney is working well. Stopping or missing them may cause a rejection of your new kidney.

You will need to learn what symptoms to watch out for in order to alert your doctors of the possibility of rejection or other surgical complication. These symptoms include:

  • A fever of more than 100 degrees
  • Drainage from your surgical scar
  • Burning when you pass urine
  • Decreased urination
  • A cold or cough that won’t go away
  • Sudden chest pain
  • Shortness of breath
  • New extreme fatigue
  • Extremity swelling
  • Excessive weight gain

You’ll have regular follow-up visits with your nephrologist (kidney specialist) after leaving the hospital. You should contact your doctor or your transplant coordinator if you have any problems you think may be related to your kidney transplant surgery.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.