Dialysis or Kidney Transplant – what is the best option for patients with end-stage kidney disease
A kidney transplant is one of the options for treatment of ‘end-stage kidney failure’, a condition where the kidneys are irreversibly damaged and function at only 10-15% of their normal capacity. Some form of renal replacement therapy (dialysis/kidney transplant) is needed at this stage to keep the patient alive.
Kidney transplant is the best modality of Renal Replacement therapy for most patients with end-stage kidney failure and should be the treatment of choice in candidates (especially young renal patients), who meet the requirements. Most patients with end-stage renal failure are candidates for a kidney transplant unless they are suffering from old age, severe heart or vascular disease, poorly controlled mental illness, chronic illness etc. which means that it is safer for them to be treated with dialysis rather than undergo a kidney transplant.
When planned carefully, a kidney transplant is a safe operation for both the recipient and the kidney donor. Kidney donors have a normal life after an operation. A kidney can be transplanted from a relative, an unrelated person (such as a spouse or friend), or from a person who has died (deceased or cadaver donor); only one kidney is required to survive. Research has shown that patients who receive a kidney from a living donor live longer than patients who receive a kidney from a deceased donor (someone who has just died).
Few facts about Kidney Transplant
- Transplanted patients live longer than those continuing with dialysis, except during the first 3 months post-transplant when the risk of infections and rejections is the greatest
- The longest surviving renal transplant recipients are well 40 years after receiving a kidney from a living donor and 34 years after receiving a cadaveric kidney transplant
- There is emerging evidence that the best outcomes accrue to patients who receive a transplant early in the course of renal replacement therapy.
Benefits of Kidney transplant
- Better Quality of Life: A kidney transplant provides a better quality of life as you are no longer restricted by dialysis sessions. Patients enjoy being able to return to work, travel more freely and live with fewer, if any diet and fluid restrictions. Also, most kidney patients feel more energetic after a transplant.
- Increased Life expectancy: The life expectancy significantly increases with transplantation as compared to staying on dialysis (except during the first 3 months after transplant).
- Helps restore fertility: Disturbances in mensuration, fertility and sexual function are common in women with chronic kidney failure or End-Stage Renal disease (ESRD). Fertility is usually restored after a transplant. This is particularly important for women because it is very rare to have a successful pregnancy whilst on dialysis.
Dr. Kamal Kumar Kaswan I Consultant – Nephrology & Transplant Medicine | Narayana Multispeciality Hospital, Jaipur