Kidney Transplant

• End-Stage Renal Disease
• Kidney Transplant Symptoms
• Kidney Transplantation
• Kidney Transplant Medical Treatment
• Outlook After Kidney Transplantation
• Follow-up
• For More Information
• Web Links
• Synonyms and Keywords
• Authors and Editors

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.
  
  
• Kidney 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. 

How the kidneys work

The kidneys have several important functions in the body.

• They filter wastes from your bloodstream and maintain the balance of electrolytes in your body.
  
  
• They remove chemical and drug by-products and toxins from your blood.
  
  
• They eliminate these substances and excess water as urine.
  
  
• They secrete hormones that regulate the absorption of calcium from your food (and thus bone strength), the production of red blood cells (thus preventing anemia), and the amount of fluid in your circulatory system (and thus blood pressure).

When blood enters the kidneys, it is first filtered through structures called glomeruli. The second step is filtering through a series of tubules called nephrons. 

• The tubules both remove unwanted substances and reabsorb useful substances back into the blood.
  
  
• Each of your kidneys contains several million nephrons, which cannot be restored if they are damaged. 

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.

People with the following conditions are at greater-than-normal risk of developing kidney failure and end-stage renal disease:

• Diabetes (type 1 or type 2)
  
  
• High blood pressure - Especially if severe or uncontrolled
  
  
• Glomerular diseases - Conditions that damage the glomeruli, such as glomerulonephritis
  
  
• Hemolytic uremic syndrome
  
  
• Systemic lupus erythematosus
  
  
• Sickle cell anemia
  
  
• Severe injury or burns
  
  
• Major surgery
  
  
• Heart disease or heart attack
  
  
• Liver disease or liver failure
  
  
• Vascular diseases -  Conditions that block blood flow to different parts of your body, including progressive systemic sclerosis, renal artery thrombosis (blood clot), scleroderma
  
  
• Inherited kidney diseases - Polycystic kidney disease, congenital obstructive uropathy, cystinosis, prune belly syndrome
  
  
• Diseases affecting the tubules and other structures in the kidneys - Acquired obstructive nephropathy, acute tubular necrosis, acute interstitial nephritis
  
  
• Amyloidosis
  
  
• Taking antibiotics, cyclosporin, heroin, chemotherapy - Can cause inflammation of kidney structures
  
  
• Gout
  
  
• Certain cancers - Incidental carcinoma, lymphoma, multiple myeloma, renal cell carcinoma, Wilms tumor
  
  
• HIV infection
  
  
• Vesicoureteral reflux - A urinary tract problem
  
  
• Past kidney transplant (graft failure)
  
  
• Rheumatoid arthritis

Chronic kidney failure is associated with complications that can be debilitating or have a negative effect on quality of life.

• Anemia
  
  
• Fluid retention
  
  
• Pulmonary edema - Fluid retention in the lungs that can cause breathing problems
  
  
• High blood pressure - From chemical imbalances and fluid retention
  
  
• Renal osteodystrophy - Weakening of the bones from calcium depletion, can fracture easily
  
  
• Amyloidosis - Deposition of abnormal proteins in the joints, causes arthritislike symptoms
  
  
• Stomach ulcers
  
  
• Bleeding problems
  
  
• Neurological damage
  
  
• Sleeping problems - Related to dialysis

Next: Kidney Transplant Symptoms »

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