Understanding Kidney Failure and Transplants

Published on Mar 20, 2015

Today more than 100,000 people in the United States are on a kidney transplant waiting list due to kidney failure. Kidney failure occurs when the kidneys can no longer do their job of removing extra fluid and filtering waste from the blood. Due to a shortage of organ donors in the U.S., only between 16,000 – 17,000 people per year for the last 10 years have received kidney transplants. According to the National Kidney Foundation, every day 13 people die waiting for a kidney, so there is a great need for people willing to be donors.

Chronic kidney disease (CKD), which can progress to end-stage renal disease (ESRD — a state of being in kidney failure) is very common in the U.S. It is most often a result of diabetes and/or hypertension. In fact, 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure have chronic kidney disease. And kidney disease is the 9th leading cause of death in the U.S. More than 20 million Americans have chronic kidney disease, many of whom are not aware of their condition.

Treating Kidney Failure

Unfortunately, no cure for ESRD exists, and there are only two treatment options. The first is dialysis, a procedure in which waste and extra fluids are filtered from your blood. There are two kinds of dialysis, including:

  • Hemodialysis, which cleans the blood a little bit at a time by running it through a special filter inside the dialysis machine. The filter removes wastes and extra fluids from your blood, but retains the proper balance of salts and minerals such as potassium and sodium. The filtered blood is then returned to the body.
  • Peritoneal dialysis, which cleans the blood using the lining of your abdomen as a filter, instead of an external machine. The dialysis solution is placed into the abdomen through a catheter (tube) so it can use the stomach tissues to clean the blood. This method allows your blood to be cleaned while you sleep, while you work, or while you perform your everyday activities.

The second treatment for ESRD is a kidney transplant, which is the surgical placement of a functioning kidney from a donor.

Both of these options may affect quality of life and can feel like trading one serious condition for another because they each require intense health care management.

Types of Kidney Transplant Donors

For those who decide to undergo kidney transplant rather than remain on dialysis, it’s important to know about the types of organ donations that are available. Kidney donations can be provided from people who are living or people who have died. Whether the donor is deceased or alive, tests will be done to determine if their blood and tissue type match the recipient’s blood and tissue type. Living donations are possible because a person who is healthy and has two perfectly functioning kidneys can donate one and live a healthy life with the remaining kidney. The most common living donors are people in the family who are willing to go through the donation process. Becoming a living donor for a family member, loved one, acquaintance or a stranger is a very personal decision. Not everyone who is willing to make a donation is able to do so.

Deceased donations happen when someone has previously indicated a wish to donate organs upon their death. The process for indicating your intention to become an organ donor is a simple one. One can register to be a future organ donor while renewing a driver’s license or by going online to the appropriate state donation registry at Donate Life America.

Preparing for a New Kidney

Receiving a new kidney requires certain responsibilities before, during, and after the transplant. Whether you are waiting for a live donor transplant or you are on the waiting list for a deceased donation, you are likely to have time to prepare prior to your surgery. There are a number of things you can do to stay as healthy as possible:

  • Follow your treatment plan according to your doctor’s instructions
  • Stay in contact with your transplant center team and inform them of any changes in your health status
  • Make sure your transplant team knows how to reach you at all times; if a deceased kidney match is made, the process happens quickly, while the organ is still viable
  • If you are on dialysis, be sure to stick with your treatment schedule
  • Follow your doctor’s diet and exercise recommendations
  • Take part in as many healthy activities as you can for your physical and psychological well being
  • Prepare yourself to commit to taking anti-rejection medication post-surgery as prescribed, indefinitely — educate yourself as to the required monitoring and possible side effects of these medications
  • Make sure that you have a good treatment plan to address the underlying cause of your kidney disease

While on the kidney transplant waiting list, it is your job to stay compliant with your doctor’s treatment plan, so that you are in the best health possible to receive a new kidney. Doing so may help improve your transplant surgery experience.

Being Realistic about Kidney Transplant

Your goal for a kidney transplant may be to return to normal activities, hobbies and work but it is important to be realistic about what life after a kidney transplant will be like. For instance, there is a life-long risk of infection and potential organ rejection, which may impact your activities and lifestyle. People with donated kidneys must remain on anti-rejection medication for life, even though they may have serious and unpleasant side effects. Some people with kidney failure may even need to undergo more than one transplant if they experience transplant failure due to rejection or other complications. For more information about what to expect after a transplant be sure to have an in-depth conversation with your healthcare team, so you are fully educated and prepared to make an informed decision.

Preventing Kidney Disease Before It Starts

It is important to remember that two of the leading causes of kidney disease, which can lead to ESRD, are high blood pressure and diabetes. If you have these conditions, speak with your doctor to discuss what you can do to slow the progression of kidney disease and failure, and take a preventive step today to keep your kidneys healthy by controlling your blood sugar and blood pressure.

Sandi See Tai, MD is the Clinical Disease Area Expert for Renal in Global Medicines Development of Pfizer Global Innovative Pharmaceutical Business. She is a trained Pediatric Nephrologist.

Debra Sierka, PharmD is a member of the US Medical Affairs team supporting the Inflammation franchise at Pfizer. She has extensive experience monitoring and educating kidney transplant patients.

[1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14]

References

  • 1. Centers for Disease Control and Prevention. Protect your kidneys. Updated March 12, 2015. Accessed March 17, 2015.
  • 2. National Institute of Diabetes and Digestive and Kidney Diseases. What I need to know about kidney failure and how it’s treated. NIH Publication No. 14-7457. Published May 2014. Accessed March 17, 2015.
  • 3. National Institute of Diabetes and Digestive and Kidney Diseases. Solitary kidney. NIH Publication No. 13-5390. Published September 2013. Accessed March 17, 2015.
  • 4. National Institute of Diabetes and Digestive and Kidney Diseases. Solitary kidney. NIH Publication No. 06-4687. Published May 2006. Updated July 30, 2014. Accessed March 17, 2015.
  • 5. National Kidney Foundation. Be an organ donor. National Kidney Foundation Web site. Accessed March 17, 2015.
  • 6. Organ Procurement and Transplantation Network. Data. Health Resources Services Administration, U.S. Department of Health and Humans Services Organ Procurement and Transplantation Network Web site. Updated March 17, 2015. Accessed March 17, 2015.
  • 7. Organ Procurement and Transplantation Network. Kidney transplants in the U.S. by state. Health Resources Services Administration, U.S. Department of Health and Humans Services Organ Procurement and Transplantation Network Web site. Updated March 13, 2015. Accessed March 17, 2015.
  • 8. United Network for Organ Sharing. Preparing yourself medically. UNOS Transplant Living Web site. Accessed March 17, 2015.
  • 9. U.S. Department of Health and Human Services. Partnering with your transplant team: the patient’s guide to transplantation. Rockville, MD: Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation; 2008. Published 2008. Accessed March 17, 2015.
  • 10. Organ Procurement and Transplantation Network. Living donation for patients. Health Resources Services Administration, U.S. Department of Health and Humans Services Organ Procurement and Transplantation Network Web site. Accessed March 17, 2015.
  • 11. Organ Procurement and Transplantation Network. How organ allocation works. Health Resources Services Administration, U.S. Department of Health and Humans Services Organ Procurement and Transplantation Network Web site. Accessed March 17, 2015.
  • 12. Organ Procurement and Transplantation Network. How organ allocation works. Health Resources Services Administration, U.S. Department of Health and Humans Services Organ Procurement and Transplantation Network Web site. Updated February 19, 2015. Accessed March 17, 2015.
  • 13. United Network for Organ Sharing. Living donation. Published 2013. Accessed March 17, 2015.
  • 14. U.S. Department of Health & Human Services. Organ donation: the process. Health Resources Services Administration, U.S. Department of Health and Humans Services organdonor.gov Web site. Accessed March 17, 2015.
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