Volume 39 Issue 8 | Nephrology Dialysis Transplantation (2024)

FAQs

Is kidney transplant better than dialysis? ›

Studies show that people with kidney transplants live longer than those who stay on dialysis. A successful kidney transplant may also allow you the freedom to live the kind of life you were living before you got kidney disease or started dialysis, including work, travel, and more time to spend with friends and family.

The average life expectancy for patients on dialysis is 5 to 10 years but many patients have lived well on dialysis for 20 or even 30 years.

Currently, the one-year kidney transplant survival rate is 95%. The average three- to five-year survival rate is 90%. This means that 9 in 10 people who receive a transplanted kidney will still be alive five years after their surgery. Survival rates are estimates.

In stage 5 CKD, you are at the highest risk for heart disease (even if your urine albumin-creatinine ratio (uACR) is lower than 30). As your uACR number goes up, your risk of developing heart disease also goes up.

Increased life expectancy with kidney transplant

For example, a 30-year-old on dialysis would have a life expectancy of 15 years. With a deceased kidney donor transplant (a kidney from someone who is brain-dead), life expectancy increases to 30 years.

You are too ill or frail to cope with the surgery and aftercare. You have recently had cancer, a serious infection, a heart attack or a stroke.

Of 532 patients starting dialysis, 222 died. The causes of death were grouped into six categories: cardiac, infectious, withdrawal from dialysis, sudden, vascular, and “other.” The greatest number of deaths were due to infections, followed by withdrawal from dialysis, cardiac, sudden death, vascular, and other.

But most people on dialysis develop calcium and phosphorus imbalance. This can lead to bone and heart disease.

Fluid overload occurs when there is too much fluid build-up in the body during dialysis, as the kidneys are no longer able to remove enough on their own. This can result in additional swelling, bloating, cramping, high blood pressure, shortness of breath and heart problems.

According to the latest data from OPTN, 13% of all kidney transplant recipients to date (including kidneys from both living and deceased donors) have been over 65, while 39% have been between the ages of 50 and 64. In 2022, 23% of all transplant recipients were over 65, and 41% were aged 50–64.

At what stage of kidney failure do you get a transplant? ›

At this stage, it is very important to slow the loss of kidney function by following your treatment plan, and managing other problems like high blood pressure or heart disease. Stage 5 is kidney failure. If kidney failure happens, you will need a kidney transplant or dialysis to live.

Whilst all fluid counts towards your fluid intake, water is one of the healthiest choices when it comes to maintaining kidney health. Sip water little and often. Women should aim to drink eight 200ml glasses of fluid a day. Men should aim to drink ten 200ml glasses of fluid a day.

Patients opting for conservative treatment tend to die when their GFR reaches approximately 5 ml/min.

We found that participants with progressive CKD spent a median of 7.9 years in stage 3a, 5 years in stage 3b, 4.2 years in stage 4, and <1 year in stage 5.

Disadvantages: The biggest disadvantage of a transplant is the availability of a suitable donor. It can also carry some risks, such as rejection of the transplanted kidney, infection, or complications related to the surgery.

Overall, the pooled estimate showed that transplantation was associated with a 55% lower long term mortality risk in patients with kidney failure compared with dialysis (hazard ratio 0.45, 95% confidence interval 0.39 to 0.54; P<0.001), as shown in fig 2.

Non Adherence (aka Non-Compliance)

Some people stop taking their anti-rejection medicines or miss doses. The anti-rejection medicine prevents your body from recognizing the donor kidney as a “foreign object.” Without enough of the medicine in your blood, your body “sees” the new kidney and begins to attack it.

You may not be eligible if you have: Current or recurring infection that cannot be treated effectively. Cancer that has spread from its original location to elsewhere in the body. Severe heart or other health problems that make it unsafe to have surgery.