Kidney Transplant

End-Stage Renal Disease

End-stage renal disease is the name for kidney failure so advanced that it cannot be reversed ("renal" is another word for kidney). The name is appropriate: the kidneys in end-stage renal disease function so poorly that they can no longer keep you alive.

End-stage renal disease cannot be treated with conventional medical treatments such as drugs. Only 2 treatments allow you to continue living when your kidneys stop functioning: dialysis and kidney transplantation.

Dialysis is the term for several different methods of artificially filtering the blood. People who require dialysis are kept alive but give up some degree of their freedom because of their dialysis schedule, fragile health, or both. idney transplantation means replacement of the failed kidneys with a working kidney from another person, called a donor. Kidney transplantation is not a complete cure, although many people who receive a kidney transplant are able to live much as they did before their kidneys failed. People who receive a transplant must take medication and be monitored by a physician who specializes in kidney disease (nephrologist) for the rest of their lives.

The National Kidney Foundation estimates that about 350,000 people in the United States have end-stage renal disease and about 67,000 people die of kidney failure every year.

• In the year 2000, nearly 47,000 people in the United States were waiting for a kidney transplant.


• Because of a shortage of donor kidneys, each year only a small percentage of people who need a transplant actually receive a kidney. The wait for a donor kidney can take years.

Kidney failure
Various conditions can damage your kidneys, including both primary kidney diseases and other conditions that affect the kidneys.

• If kidney damage becomes too severe, your kidneys lose their ability to function normally. This is called kidney failure.
• Kidney failure can happen rapidly (acute kidney failure), usually in response to a severe acute (sudden, short-term) illness in another body system or in the kidneys. It is a very common complication in patients hospitalized for other reasons. It is often completely reversible with resolution of the underlying condition.
• Kidney failure can also happen very slowly and gradually (chronic kidney failure), usually in response to a chronic (ongoing, long-term) disease such as diabetes or high blood pressure.
• Both types of kidney failure can occur in response to primary kidney disease as well. In some cases this kidney disease is hereditary.
• Infections and substances such as drugs and toxins can permanently scar the kidneys and lead to their failure.

Kidney Transplantation

Kidney transplantation is replacement of nonworking kidneys with a healthy kidney from another person (the donor). The healthy kidney (the "graft") takes over the functions of your nonworking kidneys. You can live normally with only one kidney as long as it functions properly.

The transplantation itself is a surgical operation. The surgeon places the new kidney in the abdomen and attaches it to the artery that supplied blood to one of your kidneys and to the vein that carries blood away from the kidney. The kidney is also attached to the ureter, which carries urine from the kidney to the bladder. The old kidneys are usually left in place unless they are causing you problems, such as infection.

Every operation has risks, but kidney transplantation is not a particularly difficult or complicated operation. It is the period after the surgery that is most critical.

Are you eligible for a transplant?

Before you can receive a kidney transplant, you must undergo a very detailed medical evaluation.

• This evaluation may take weeks or months and require several visits to the transplant center for tests and examinations.
• The purpose of this thorough evaluation is to test whether you would benefit from a transplant and can withstand the rigors of the surgery and antirejection medications and the adjustment to a new organ.

Potential kidney donors also must be in good health and undergo a thorough medical evaluation.