By Leslie Spry, MD FACP FASN
As flu season approaches, kidney patients need to know what they can do and what they should avoid if they become ill. The first and most important action to take is to get a flu shot. All patients with chronic kidney disease, including those with a kidney transplant should have a flu shot. Transplant patients may not have the nasal mist flu vaccine known as FluMist®. Transplant patients should have the regular injection for their flu vaccine. If you are a new transplant recipient, within the first 6 months, it is advisable to check with your transplant coordinator to make sure your transplant team allows flu shots in the first 6 months after transplant. ALL other kidney patients should receive a flu vaccination. This year, there are two variations of the flu vaccine: trivalent vaccine and quadrivalent vaccine. The traditional vaccine protects against three strains of the flu while the newer quadrivalent protects against four different flu viruses.
If the influenza virus is spreading in your community, there are medications that you can take to protect against influenza if you have not been vaccinated, however the dose of these medications may have to be modified for your level of kidney function. This is also true of antibiotics or any medication that you take for colds, bacterial infections or other viral infections. The doses of those medications may have to be modified for your level of kidney function. Even if you are vaccinated, it is still possible to get influenza and pneumonia, but the disease is usually much milder.
You should get plenty of rest and avoid other individuals who are ill, in order to limit the spread of the disease. If you are ill, stay home and rest. You should drink plenty of fluids to stay well hydrated. You should eat a balanced diet. If you have gastrointestinal illness including nausea, vomiting or diarrhea, you should contact your physician. Immodium® is generally safe to take to control diarrhea. If you become constipated, medications that contain polyethylene glycol, such as Miralax® and Glycolax® are safe to take. You should avoid laxatives that contain magnesium and phosphates. Gastrointestinal illness can lead to dehydration or may keep you from taking your proper medication. If you are on a diuretic, it may not be a good idea to keep taking that diuretic if you are unable to keep liquids down or if you are experiencing diarrhea. You should monitor you temperature and blood pressure carefully and report concerns to your physician. Any medication you take should be reported to your physician.
Medications to avoid include all non-steroidal medications including ibuprofen, Motrin®, Advil®, Aleve®, and naproxen. Acetaminophen (Tylenol® and others) and aspirin are generally safe to take with kidney disease. Acetaminophen doses should not exceed 4000 milligrams per day. If you take any of the over-the-counter medications, you should always drink plenty of water and stay well hydrated. If you take anti-histamines or decongestants, you should avoid those that contain ephedrine or pseudoephedrine. Over-the-counter cold remedies that are safe to take for patients with high blood pressure are generally designated “HBP”. Any over-the-counter medication that you take for a cold or flu should be approved by your doctor.