About 10% of the world population is suffering from chronic kidney disease (CKD) or kidney-related ailments.1 A number of factors contribute to the rising incidence of CKD, which affects people across various age groups. Patients with CKD gradually see a decline in kidney function. Although appropriate changes to lifestyle and diet, combined with a good treatment plan, can preserve kidney function for a long time, end-stage kidney disease is a distinct possibility, one that requires a very different treatment plan.
A kidney transplant is usually recommended when a patient has end-stage renal disease. It can also be suggested as an alternative when the condition of the kidney is steadily declining in spite of medicines.
Since going under the knife is never an easy decision, a constant dilemma that people with CKD face is whether they have options other than a transplant.2
However, a kidney transplant is not the only available alternative. The options for treating CKD include:
- Conservative management: A less common option than dialysis or transplant that can help you manage the condition. It involves a carefully structured diet, medicines, and a lifestyle plan to prevent further deterioration of the kidney function and maintain quality of life.3
- Dialysis: The process of removal of waste from the body and purification of the blood through external support called the dialysis machine. The two types of dialysis are haemodialysis and peritoneal dialysis.
- Kidney transplant: A fresh kidney is transplanted from a donor (either living or dead), which replaces the damaged kidney.3
Kidney transplants are widely recommended by doctors to patients with end-stage kidney disease for the following reasons:3
- They may give the patient a longer and healthier life, increasing their lifespan by nearly 30 or 40 years.
- They can ensure a better quality of life. Patients are able to work, travel, and live a normal life.
- They reduce restrictions on diet and lifestyle.
- They improve energy levels and overall health.
- They cause fewer health complications or minor ailments.
- They do not have any side-effects like dialysis, e.g., lowered red blood cell count and heart ailments.
The patients typically stay in the hospital for a few days to a week after surgery, after which full recovery can be done from home.4
Given that patients with end-stage kidney disease can experience such great relief and benefits, the question that arises is, “Why is transplant not suggested to everyone more readily?” A major difficulty faced with transplant is that it is not easy to find a donor. It is tougher, still, to find a donor who will be a perfect tissue match. Also, the risk of kidney rejection is fairly high, which can lead to failed kidney transplant procedures.4
Not everyone is eligible for a kidney transplant, so it is best to evaluate your individual needs with your doctor. There are several cases when patients will have to continue with dialysis or medical management. Patients who may not be eligible for transplant include:2,4
- Those recovering from or being treated for cancer
- Those suffering from a terminal illness
- Those who are not healthy enough for surgery due to a heart condition or other serious conditions
- Those who suffer from weight-related issues
- Those who have mental health issues and problems including amnesia or dementia
- Those who suffer from alcohol or drug abuse
- Those who cannot handle the side-effects of surgery as per their physicians
Although kidney transplant is considered to be one of the best courses of treatment for patients with CKD and end-stage kidney disease, it may still not be the only option available and one can still live a fulfilling life without a transplant.
- Global facts: About kidney disease [Internet]. [Mar 2015; cited Oct 15, 2019]. Available from: https://www.kidney.org/kidneydisease/global-facts-about-kidney-disease
- Choosing a treatment for kidney failure [Internet]. [updated 2018 Jan 31; cited 2019 Sep 27]. Available from:https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/choosing-treatment
- Conservative Management for Kidney Failure [Internet]. [cited 2018 Jan 31]. Available from: https://www.niddk.nih.gov/health-information/kidney-disease/kidney-failure/conservative-management
- Mayo Clinic Staff; Kidney transplant [Internet]. [cited 2019, August 20]. Available from https://www.mayoclinic.org/tests-procedures/kidney-transplant/about/pac-20384777