So often, we talk about medical care like itБs clear-cut: You have a problem, you see a doctor, and, hopefully, you get a solution. But itБs not always that simple. Finding the problem itself can be a challenge, and when it comes to the right treatment, itБs often about understanding tradeoffs. If you have a loved one with chronic kidney disease, itБs no different. The kidneys are so important because they remove waste from the body. And they keep really busy doing it — they filter about 45 gallons of blood every day. So when they stop working as well, waste and fluids build up. That leads to issues like high blood pressure, and at some point, kidney failure. Someone with chronic kidney disease has two main options. They can get a transplant to receive a healthy kidney from a donor. Or they can start dialysis, a treatment where blood gets filtered either by a machine or in the belly with the help of a special tube. You might think that a transplant is more of a last resort, the thing to do when youБve run out of options. But thatБs hardly the case. For most people, doctors prefer transplant over dialysis. Why do doctors prefer transplants? The reason is simple: People who get transplants generally live longer than those who get dialysis. For example, an adult whoБs 30 and on dialysis might live another 15 years. With a transplant, that number jumps to 30-40 years. Not only do people who get transplants usually live longer, they also tend to have:
Better quality of life.
They donБt spend hours each week getting dialysis, and theyБre more likely to go back to work. Also, dialysis can take a toll on the body. It can cause problems ranging from anemia, where you have fewer red blood cells, to heart disease. б If transplants are better, why do so many people get dialysis? Mainly, because there are many more people in need of kidneys than there are donors. Many people go on dialysis because they need to. They have no other choice while theyБre on a waiting list for a donor kidney. And for them, dialysis is a lifesaver. б The most common reason for a kidney transplant is end stage kidney disease or kidney failure. The kidneys are two bean shaped organs on each side of the lower abdomen near the back. These organs get a regular blood flow from the large renal blood vessels that bring in the blood from the body. There are millions of tiny filters, known as nephrons within the kidney. These help to filter out the harmful waste products and chemicals in blood and filter out excess fluid as well to form the urine. The urine then flows out of the kidneys via the ureters into the urinary bladder from where it is passed out of the body via the urethra. With disease these nephrons become damaged, the kidneys can lose their filtering abilities. This means high and life threatening levels of waste products and chemicals in the body.
When the kidneys have lost around 90% of their filtering ability, the person is said to have end stage kidney disease. Diabetes в These patients have a continuously high blood sugar. This high blood sugar can damage the filters in the kidneys, leading to long-term kidney damage and finally kidney failure. This is called diabetic nephropathy. or hypertension в This is another common cause of kidney disease and failure. High blood pressure in the tiny blood vessels to the kidney leads to damage and prevents the filtering process from working properly. Another condition is called polycystic kidney disease which is an inherited condition. There are several large cysts or hollow spaces formed within the kidney that make its normal functioning difficult. There may be congenital problems in development of kidneys. This occurs since before birth and manifests when over 90% of the kidney function is compromised. Disease of the immunity such as systemic lupus erythematosus (SLE) in which the immune system of the body fails to recognise the kidney as its own and attacks it thinking it to be a foreign object. End stage kidney disease needs treatment to prevent life threatening consequences of the waste product build up leading to coma and death. In these situations dialysis is an option. A device is used to filter the blood as it flows through it and the filtered blood is then injected back into the body.
This is a time consuming, expensive procedure and is associated with a myriad of side effects and risks of infection etc. Kidney transplant, if possible, is usually the preferred option because it is much less inconvenient than having dialysis. When can a kidney transplant take place? A kidney transplant may be performed regardless of age of the recipient (patient who requires the kidney) provided they have a general health status that can withstand the major operation, there is a good chance of transplant success and the person is aware and willing to comply with taking immunosuppressant medications after the transplant to prevent rejection of the new organ by the bodyвs immune system. Who cannot use a kidney transplant? those with a widespread cancer, those with an active infection, those with liver or heart disease, those with AIDS. Patients requiring a kidney transplant may need to wait on the waiting list for an average of around two years. Those with rarer blood groups tend to wait longer than those with a common blood group. Those on the list must be prepared for the operation at a very short notice. While on the list the patient may be maintained on dialysis and must attempt to remain as healthy as possible by adopting healthy diet and exercise regimen. Reviewed by April Cashin-Garbutt, BA Hons (Cantab) Last Updated: Jan 22, 2014