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Treatment

  • Assessing Kidney Function with eGFR

What is Chronic Kidney Disease

When the kidney function reduces, the advanced concept called Estimated Glomerular Filtration Rate (eGFR) is used to determine the extent of the damage. Your doctor will calculate it based on your age, creatinine level, and other health factors, and you will need to work on understanding, accepting, and taking the right action to find the best treatment suitable to you. The treatment varies depending on the severity of your condition and may include medications that help manage symptoms to a certain level.

Renal Transplant

Kidney Transplant or Renal Transplant is the process of placing a donor’s kidney in your body to take over the function of your failed kidney.
This kidney could be from a:

  • Living Donor
  • Deceased Donor (Cadaver)

Living Donor Transplant

In this type of transplant, a healthy kidney is donated by a willing relative, friend, or even a stranger. Transplanted kidneys from living donors can last almost twice as long as kidneys from deceased donors.

Cadaveric Transplant

If a living donor kidney is unavailable, you will need to register for a transplant from a deceased donor. It usually requires a waiting time of a few years depending on the availability of a matching kidney, your age and health condition, and a few other factors. Cadaver kidneys become available when the family members of a deceased person decide to donate his or her organs at the time of death.

Renal transplantation is considered the best choice of treatment for end-stage renal disease (ESRD) because it can increase your chances of living a longer healthier life. However, many people are unable to get a transplant due to various reasons.  

Reasons for inability to get a transplant:

  • No willing or suitable donor among family members
  • Insufficient cadaver donations resulting in long waiting queues for cadaveric kidneys
  • Strict rules for transplant that make it difficult for people to get past all documentation
  • Delays in the process, that result in health complications, infections, or increased antibodies in the second transplant in patients
  • Not being healthy enough for transplant due to age or other pre-existing medical conditions

Some conditions are known to recur in the transplanted kidney (e.g., IgA nephropathy, oxalates- Calcium that is difficult to be absorbed, gets deposits to form stones. In this case, kidney + liver transplant is needed, certain types of glomerular disease, and diabetes). However, the rate of recurrence is low enough to justify transplantation. Renal transplantation has shown significant improvement in early graft survival and long-term graft function, making it a more cost-effective alternative to dialysis.

The prognosis after kidney transplantation is generally excellent, with one-year graft survival rates ranging from 90% to 95%.

 

Organ Transplantation involves legal procedures. Rules can vary from state to state. Your nephrologist and transplant coordinator will explain these to you as part of your transplant process. You could also contact your KWF State Coordinator to get more details.

 

Kindly talk to your nephrologist for full information. The information given here is only indicative. Please get your medications prescribed by your doctor. Your doctor knows your health better

Dialysis

Dialysis is the artificial process of helping your body get rid of waste, excess water, and filtering the blood. It is not as effective as the function of healthy kidneys which work 24*7 but is necessary for survival once a patient enters end-stage renal disease (ESRD) and until he has a successful renal transplant.

There are two main types of dialysis. Factors like health condition, affordability, availability of equipment, etc. influence the choice of dialysis for a patient.

When will I start Dialysis?

Many factors are considered before your doctor will start you on dialysis. It will be based on your eGFR and general health condition. The doctor will advise you. This is the time to discuss with your doctor the best option that will be suitable for you.

Access needs to be created for dialysis.

  • A fistula surgery is needed for Hemodialysis and Home dialysis
  • A catheter needs to be fixed for Peritoneal Dialysis

Hemodialysis

Hemodialysis is a treatment done at a dialysis center, where a machine is used to filter your blood. For millions of patients with end-stage renal disease (ESRD), hemodialysis has been the most preferred choice, as trained technicians take care of the treatment.

An AV fistula is a surgical procedure, connecting an artery and a vein for dialysis access.

The goal is to allow high blood flow so that the largest amount of blood can pass through the dialyzer. This is necessary for hemodialysis. The fistula takes about two to three months to mature before it can be used. For patients who require dialysis right away, a venous catheter is recommended. This is a tube that is inserted into a vein in the neck, chest, or leg.

Home Dialysis

Home dialysis is hemodialysis done at home. It is possible to do dialysis every night for 5-6 consecutive days so you feel healthier with the regular removal of waste from the blood.

Very few patients opt for this treatment as it requires the setup of a dialysis machine and equipment at home, and also a personal dialysis technician to monitor the process.

Peritoneal Dialysis

Peritoneal dialysis uses the lining of your abdomen, also known as the peritoneum, as a natural filter to clean your blood inside your body. A solution called dialysate is filled in the peritoneum and allowed to remain in your abdomen for a certain period of time to draw out waste and fluid from your blood. Since Peritoneal dialysis can be done at home, it allows for more flexibility for treatment.

People can continue to pursue work and education as they save on time needed to commute to the center. The diet prescribed for a patient undergoing this procedure has fewer restrictions. However, strict standards of hygiene need to be maintained to prevent infections. Sufficient storage space is also needed for maintaining the supplies in good condition.For peritoneal dialysis, one requires a catheter to be fixed in the peritoneum (which is the lining of the abdominal cavity) of your belly.