The need for post-kidney transplant care in the United States is increasing. In 2011, 17,671 patients received kidney transplants and 181,000 people were living with a transplanted kidney.The rising demand for care required by kidney transplant recipients (KTRs) and the decreasing availability of nephrologists poses a dilemma. The growing number of physician assistants (PAs) offers a valid solution. A physician assistant (PA) is a mid-level state licensed healthcare professional who practices medicine under the supervision of a physician. PAs practice medicine in many countries including the United States, Puerto Rico, Canada, the United Kingdom, the Netherlands, Germany, and Saudi Arabia. Of the 93,098 PAs in the United States, 32% practice in primary care.While transplant centers assume the complex care of patients before and immediately following transplantation, primary care PAs can offer healthcare maintenance throughout the remainder of the patient’s life. This review provides PAs essential elements to consider when providing care for the growing population of KTRs.
Primary care PAs should monitor water and electrolyte balances in KTRs. Diarrhea is prevalent in 11.5% of KTRs the first year, 17.5% the second year, and 22.6% in the third year post-transplantation.Diarrhea leads to malabsorption, dehydration, and immunosuppression; all of these factors can lead to re-hospitalization and increase the likelihood of graft loss and death. These outcomes are exacerbated (2-fold increase) if the diarrhea is noninfectious.