Transplant vs dialysis

[Abharathan]

Dialysis vs Transplant

Is long term hemodialysis a viable option for one with ESRF, diabetes, hypertension and cardio vascular disease

[Cap21_NKF Partner]

Dialysis vs a transplant is a decision that either a patient makes out of personal preference or the doctor will normally suggest one or the other due to the patient's health condition. Both are recommended treatments for End Stage Kidney Failure. I suggest consulting with your general practitioner about the best option for you.

[OperationKidney]

I recommend transplant only because it's the most long term solution for most people and could help alleviate some of the other things you're dealing with. However like Cap21 said it is a personal choice and depends on several factors.

[WYOAnne NKF Ambassador]

It really does depend on the discussion you have had with your nephrologist and what he recommends.Just my opinion, but at age 52, I would not want to be on dialysis for the rest of my life.

I do not have any of your health issues and had a transplant when I was 49 and now 22 years later I continue to do great.

[Darlenia]

It's a great question and it's wonderful you are looking ahead and examining options. Your nephrologist will be the one to advise you. Indeed, our transplant center required our nephrologist's referral before seeing my hubby. My hubby, who was on PD dialysis, managed to receive a transplant this year at age 71. He's a T2D with hypertension with a heart stent. (Some centers are more risk tolerant than others.) After many complications from the transplant, my husband is happy he chose a transplant. Throughout, however, we have become very aware of the pluses and minuses of either decision in his situation. Yes, both transplant and dialysis are used long term, but it's generally accepted a transplant leads to a longer lifespan. Of course, much depends on one's overall health. Chat with your nephrologist and see where that conversation takes you.

[DexterLab]

All my doctors were very pro-transplant, and even wanted me to get a pre-emptive transplant from a living donor to avoid dialysis altogether. On average, people survive longer with a transplant than with dialysis. However, for some people a transplant is impossible, for one reason or another. A brother of one of my church members has been on peritoneal dialysis for 30 years, since he could not get a transplant. He is a doctor, so that training may be essential to his success. You should really have the discussion with your nephrologist and the transplant center for your particular situation.

I got a living donor kidney before I had to go on dialysis (and that would have probably been only a few months away) 34 months ago. Stuff that was screwed up for 20 years was better in 4 days. I am pretty ok with the meds, and certainly much better off after than before. Dialysis would seem to be scary in these Covid times, but I would not know from personal experience. I am ready to stop being a hermit, but that day has not yet arrived.

Good luck.

[Deanof316]

There's no debate in my view, assuming the person can handle the surgery and the immunosuppressants, transplant will always trump dialysis, especially haemodialysis. As a 'contest' it's not even close!

[Hidden]

Howdy…As my wife says, both dialysis and transplant are life saving technologies. I do believe that transplant is considered more of the gold standard when it comes to treatment for ESRD. But, if I needed to do dialysis again I would surely do it. And, one never knows how the medical technology landscape will change in the next decade. I’m hoping if I should need another transplant new options, for treatment, will be available.

[redpanda67]

I was on dialysis for 10 years during my 20s. It sucked! I do know people who had been on dialysis for 20+ years. Most of these people were extremely disciplined and were dedicated to exercising, working, and carefully watching their diets. Although you can make it work the older you get the greater risk you are from cardiovascular diseases, like stroke and heart attacks. It also depends on the type of dialysis. PD can be much better for your heart because you don't have the drastic change in fluid levels and tends to be less limiting for eating a greater variety of foods. I did PD for about 4 years, but like most people, I ended up with too many infections and had to switch back to hemodialysis. There are also various types of hemo that can really make a difference in your cardiac health and diet.

Transplant - I was on the list for 9 years. I can eat a larger variety of foods, have more energy, no itchy skin or restless legs. However, transplants are a treatment - not a cure and have their own level of problems. Every person is different. I have never had problems with my immune system, but I have gained weight, had mood swings, increased blood pressure, and become pre-diabetic. Some of this would likely have happened regardless of the transplant because I had my transplant when I was 30, and some of this is just related to weight gain in my 40s.

Despite all the issues I have had with my transplant, I would never wish dialysis on anyone. This is entirely my opinion. I lost half my body weight, could no longer walk, and was on death's door too many times to count while on dialysis. I had friends die on dialysis and one who died a few months after transplant. There are no guarantees either way. I would say at least go through the workup for the transplant, it can take months. You can always take yourself off the list if you decide dialysis works for you.

Hopefully, in 10-15 years we can just make new kidneys. I heard this while on dialysis, but I now have colleagues who are working on this technology so it's becoming more real.

[RonZone in reply to redpanda67]

Hey, keep us all posted on the work your colleagues are doing concerning "making new kidneys"! I had PD catheter placement surgery yesterday. Will start PD in a couple or three weeks.

[LisaSnow]

On the population level, more than 50% of dialysis patients died within 5-years after starting treatment whereas less than 20% of transplant patients died 5-years after the transplant. Individual characteristics will determine which treatment is right for that person but in general, transplantation leads to a lower mortality rate.