Blood vessels in your kidneys, called glomeruli, filter your blood, removing waste products and excess water. If you have chronic kidney disease, these blood vessels become damaged over time. When your kidneys can no longer filter blood, you have end-stage kidney disease (kidney failure).
Kidney failure is a serious condition that requires treatment. Doctors treat most people who have kidney failure with dialysis or transplant.
Dialysis is an alternative method of filtering your blood. There are two types:
- Hemodialysis: Doctors use a machine and a special filter to clean your blood. Most people have dialysis three times per week (about four hours per session).
- Peritoneal dialysis: Doctors help you use the lining of your abdomen (peritoneum) instead of your kidneys to filter blood. They insert a flexible tube into your abdomen and use that tube to fill your abdomen with a special fluid to flush out toxins. You’ll learn to manage this fluid exchange on your own at home.
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Dialysis vs. Kidney Transplant: Pros and Cons
Dialysis helps many people with kidney failure to get healthier. The process does the work that your kidneys can no longer do. But there are some downsides to dialysis.
Dialysis is time-consuming. It can also be exhausting and take a toll on your body. Your doctor might not recommend dialysis if you:
- Have other medical conditions, like cancer or heart problems.
- Are older than 80.
- Are too fatigued after dialysis treatment.
But dialysis is a good option if you need treatment while waiting for a kidney transplant. According to a data report from the Organ Procurement and Transplant Network, as of June 30, 2021, 98,068 people were waiting for a donated kidney.
“Dialysis is a vital therapy for many with advanced kidney disease but can have restrictions on life choices. Transplantation provides the best alternative to live a near-normal life,” says Dr. Rajesh Govindasamy, medical director of the UPMC Hamot Kidney Transplant Program.
With a kidney transplant, you receive a new healthy kidney. You might feel like you did when your own kidneys were healthy. A kidney transplant might be right for you if you’re generally healthy enough for surgery.
Is Kidney Transplant a Better Treatment Option Than Dialysis?
A kidney transplant can improve your health and eliminate the need for dialysis. But kidney transplants also have some downsides. As with any surgery, there’s a risk of infection.
After surgery, your doctor will prescribe immunosuppressant drugs to keep your body from rejecting the new organ. You’ll need to stay on these medications for as long as you have your transplanted kidney.
There’s also a chance that your new kidney will eventually fail. You may need to have more than one kidney transplant surgery.
Kidney transplant types
There are two types of kidney transplant:
- Deceased-donor kidney transplant: Surgery to replace a diseased kidney with a healthy kidney from a person who has died.
- Living-donor kidney transplant: Surgery to replace a diseased kidney with a healthy kidney from a living person who decides to donate.
Most people who have a kidney transplant receive an organ from a deceased donor. People with end-stage kidney disease may spend years on the transplant list waiting for a kidney to become available. For some, living kidney donation is a faster option.
Living donation is when a person you know (or even a stranger) decides to donate one of their kidneys to you. When doctors confirm that you and the donor are a good match, you can have transplant surgery right away.
“Living-donor kidney transplant is considered a frontline treatment for advanced kidney disease,” says Dr. Govindasamy. “In addition to eliminating or shortening time spent on dialysis, it allows the donor and recipient to schedule the transplant at a time that is mutually convenient.”
Preemptive kidney transplant
When kidney disease worsens, your doctor may recommend a preemptive kidney transplant. If a healthy kidney is available, such as from a living donor, you’ll have transplant surgery before your kidneys fail completely. This means people who have preemptive kidney transplants have surgery before needing dialysis.
Early kidney transplant
An early kidney transplant is a surgery that happens when your kidneys have failed, but you’ve only been on dialysis for a short time. With an early transplant, you won’t stay on dialysis for a long time. According to the National Kidney Foundation, avoiding dialysis may lead to a better quality of life.
How Living Kidney Donation Can Help
Talk with your doctor to see if you’re a candidate for living kidney donation. Preemptive or early transplant with a kidney from a living donor can help restore your health.
You don’t need to have dialysis first if a living kidney transplant is available. In fact, not having dialysis means you avoid risks such as:
- Low blood pressure.
- Cramping in the muscles.
- Increased possibility of sepsis (blood poisoning).
You may also have increased energy after a kidney transplant. You may feel more up to participating in work and family obligations and revisiting your favorite activities.
Editor's Note: This article was originally published on , and was last reviewed on .
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About Transplant Services
For more than four decades, UPMC Transplant Services has been a leader in organ transplantation. Our clinicians have performed more than 20,000 organ transplant procedures, making UPMC one of the foremost organ transplant centers in the world. We are home to some of the world’s foremost transplant experts and take on some of the most challenging cases. Through research, we have developed new therapies that provide our patients better outcomes — so organ recipients can enjoy better health with fewer restrictions. Above all, we are committed to providing compassionate, complete care that can change – and save – our patients’ lives. Visit our website to find a provider near you.