Did you know?

Pain is an unpleasant feeling that happens when a part of your body is hurt by injury or disease. After your kidney transplant surgery, in the first days you will probably be given medications to help alleviate the pain associated with the surgery. Your nurse/physiotherapist will instruct you about coughing and deep breathing exercises to prevent pneumonia and will help you get out of bed many times a day to prevent blood clots from forming in your legs, muscle weakness and bowel issues. Later, in the first 1 to 2 weeks after your transplant, your belly and side will continue to be sore around the cut (incision) the doctor made. It is also common for you to have some numbness around the cut, but this feeling should go away once your body heals.

Living with Chronic Kidney Disease

People living with chronic kidney disease may also have pain from different medical conditions. If your pain is related to your kidney problem, such as leg cramps, restless leg or nerve pain, you may feel less pain when your transplanted kidney starts to work. But if your pain is because of other medical conditions, such as nerve pain from diabetes or joint pain from arthritis, this pain will not go away after a kidney transplant.

About half of all transplant recipients experience some pain after their transplant. Transplant recipients may describe the pain as burning, stabbing or dull “bone pain”. Good pain control after a kidney transplant is important for a successful result. Poor pain control can cause:

  • Discomfort
  • High blood pressure
  • Fast heart rate

If your pain is not well controlled, this can interfere with:

  • your day-to-day tasks.
  • your quality of life.

It can also lead to problems:

  • such as how well your transplanted kidney works.
  • with more depression than patients with no pain.

Different methods can be used to treat pain after transplant. Your transplant team can tailor treatment for you to get the best results. You must avoid over-the-counter pain medications, such as ibuprofen, naproxen, or other non-steroidal anti-inflammatories (NSAIDs), because they can be harmful to the transplanted kidney. If you want to use any over-the-counter medications, check with your transplant team first.

How am I doing?

You can complete this pain tracking table and bring to your post-kidney transplant clinic for your team to review:

  • for this table, you will rate your pain on a scale from 0 to 10.
  • a pain level of 0 means you do not have any pain.
  • a pain level of 10 is the worst possible pain.
  • if you do take any pain medication, please write that down with the time, dose and whether it worked.

The key here is not only the time of day and the activity that causes pain, but also to track the effects of certain medications that be associated and causing the pain (e.g. anti-rejection medications).

What can I do ?

  • Try taking some slow deep breaths, close your eyes and meditate; this can help your body to feel relaxed.
  • Work with your social worker if anything is causing you stress, anxiety or anger.
  • Be careful not to lift more than 10 pounds for the first two weeks after your surgery.
  • Follow your medical team’s advice for what medication you can take to relieve your pain.
  • If your pain becomes unbearable, phone your transplant team for advice.

How can I do it?

  • To practice deep breathing and mindful meditation, find a quiet dark space where you can sit in a comfortable position to relax your body and clear out negative thoughts.
  • Have your support person help you pick up groceries or have them delivered to avoid having to lift anything heavy.
  • Fill out the pain diary above to help your kidney team see when you have pain and how bad it is.
  • Be patient with yourself during the recovery process.
  • Do not push yourself too hard when you exercise.

More Information

This section was written by Dr Jessica Donnan (RN BScN MHA, General Nurse educator, Providence Health Care, British Columbia/Canada); Marianna Leung (PharmD, ACPR, BScPharm, BCPS, FCSHP; Clinical Pharmacy Specialist-Renal Transplant) and Tanveer Brar (BSc, BSc(Pharm), ACPR).And reviewed by James Myers (kidney transplant recipient); Kent Bressler (MA RN; kidney transplant recipient); AND by our research team.

References

  1. Forsberg A, Lorenzon U, Nilsson F, Báckman L. Pain and health-related quality of life after heart, kidney, and liver transplantation. Clin Transplant. 1999;13(6):453–460.
  2. Lazowski T. The Influence of the Type of Anaesthesia on Postoperative Pain After Kidney Transplantation. Ann Transplant. 2000;5(1):28-29
  3. Gervirtz, C. Managing Post Transplantation Pain Syndromes. Nursing. 2009;39(2):60-61Chadha R, Pai SL, Aniskevich S, et al. Nonopioid Modalities for Acute Postoperative Pain in Abdominal Transplant Recipients. Transplantation. 2020;104(4):694-699.
  4. Mulka-Gierek M, Foroncewicz B, Paczek L, et al. Nonsteroidal Anti-Inflammatory Drugs and Analgesics Use by Kidney Transplant Recipients. Ann Transplant. 2018;23:153-159.

Helpful links

Testimonial

“When I was transplanted 34 years ago my main goal was to get up and walk as soon as possible. When I left the hospital my goal was to exercise and continue to live. My pain level was minimal after I got up and going. Everyone is different but recovery is impacted by initiating immediate movement and you can’t do that without pain control. Pain medicines are great but they are addictive and can be overused.”

This brief testimonial was written by Kent Bressler (kidney transplant recipient)