Gotta Share!

Today I spent in Elizabethtown, Kentucky, at an all-day Nephrology Conference updating my knowledge, visiting with old friends/former colleagues, and meeting new folks.  Since I've cared for hundreds of patients with end-stage kidney disease, I'd like to share with you some of the hardships of their lives, and how you can prevent developing this tragic disease.  You may want to share the information with those you love.

Our kidneys filter our blood, all day, every day.  End-stage renal disease (ESRD) means that your kidneys can no longer clear the extra fluid and harmful wastes from your body.  You may not urinate at all.  This disease does not happen suddenly; it develops over years, most often as a side effect of poorly regulated diabetes or high blood pressure.

The treatment options for ESRD are dialysis or kidney transplant.  Either treatment will not cure the disease but - if you follow the treatment plan prescribed by your medical professionals very carefully, you can live with this disease. Nearly 400,000 United States residents receive some form of dialysis.  172,000 U.S. people are living with working transplanted kidneys.  Without dialysis or transplant, you will die with ESRD.

So as to not make today's blog extremely long, I'll start today with the best option, kidney transplant, then explore other topics in later blogs.  Statistically, persons with ESRD who receive transplanted kidneys live longer and enjoy a better quality of life than those who have dialysis.  There are many more who need kidney transplants than there are kidneys available, either from living donors or from those who have died suddenly.  If you need a kidney, you will be evaluated to see if you can undergo the surgery and take good care of the kidney.

To be a good candidate for kidney transplant surgery, (1) you cannot be very much overweight.  Why?  Because it's harder for the incision to heal in the very obese; sometimes the surgical incisions will pop open the stitches or staples (dehiscence).

(2) You have to be "compliant" with your prescribed medical treatment, taking your medicines all the time, going to your dialysis sessions without fail, eating a healthy diet (there are many things NOT good for you if you're on dialysis, plus, you may have to limit the fluid you drink).  Don't ever think medical professionals are MEAN when we tell you what to eat, drink, get exercise, etc.  We're trying to help you!

(3) You must live within 24 hours of a transplant center.  That's the optimal time a kidney from a deceased donor can be saved for you.  A living donor has no such time limits.

(4) You may not have an active infection.

(5) You may not be older than 70 to 75 unless you are in good physical condition.

(6) You have to have a life expectancy of at least 3 to 5 years, no matter what your age.  You won't be transplanted if you have active cancer.

(7) You must have a support system at home.  You won't be sent home alone after transplantation.

(8) If you smoke, you won't be transplanted at the University of Kentucky although some other centers may take you.

(9) You must have your teeth in good condition.

(10) You cannot be a current drug or alcohol addict.

(11) You cannot be "sensitized," previously had multiple blood transfusions, pregnancies, or transplants.

The average waiting time for a kidney transplant (deceased donor) at the University of Kentucky in Lexington and at Jewish Hospital in Louisville is from 2 1/2 to 3 years.  At the University of California at Los Angeles, the wait time is ten to twelve years.

If you receive a kidney transplant, you will NEED to take anti-rejection medications for the rest of your life.  Your immune system will be considerably weaker, so you will need to avoid infections.

With all these criteria for transplants, you may be thinking: if I have extra weight, why not lose it now?  If I either smoke, am addicted to drugs or alcohol, why not quit now?  If I don't think the doctors know what they're talking about, and choose not to be "compliant" with their treatment, why not do what they say now?  If I have diabetes or high blood pressure, why not do exactly what the doctor says and very tightly regulate my illnesses NOW?  If you do this, you may stay healthy!!  Believe me, working hard to PREVENT end-stage renal disease will pay off in better health for you!!

Part of being in close relationships is wanting the best for the ones you love.  We must try to show good example in health habits and encourage (not nag!) those health habits in our loved ones.

Dear Lord, bless all those associated with the care of patients with kidney disease and all other diseases.  Please help all the sick patients not be discouraged and live the best they can.  We remember how very many sick people You healed when you were on this earth!