People who do not have good kidneys are very sick. Kidneys do many things that are important to stay healthy. Normal kidneys perform several important tasks that keep the body in good health:
Clean your blood and remove waste products through the formation of urine
Balance fluids in the body by controlling water and salt concentrations
Maintain the balance of the bodys chemicals (potassium, calcium, magnesium and phosphorus)
Control blood pressure
Supply elements used to make red blood cells, which carry oxygen in the blood
Help sustain strong bones.
One kidney, functioning at 20% capacity, can do all of the above. The kidneys produce urine that drains through narrow tubes (called ureters) into the bladder. Every day the kidneys filter 160 quarts of fluid from the bloodstream, removing about 1-1/2 quarts of waste in the form of urine.
There are two ways to replace the kidneys: dialysis and transplantation. Dialysis is when doctors use a machine and medicines to do the work that kidneys do. A better way to do the kidneys work is to give the person another kidney. To be a candidate for immunotherapy, the patient must be in good general condition, have adequate function of vital organs (such as the heart, lungs and kidneys) and have no brain metastasis.
For those with kidney failure, kidney transplants are preferable to treatment by dialysis. Kidney transplants are designed to treat patients whose kidneys are failing, making them unable to process body waste products. Transplants done relatively soon after starting dialysis are on average more successful than transplants performed two or more years after a patient starts dialysis. Patients who receive live donor kidney transplants usually have much shorter waiting times than those who receive kidneys from deceased donors. Transplants of kidneys from younger donors tend to survive longer than transplants from older donors.
Kidneys are allocated based on, among other considerations, the match between the donor and recipient blood groups and genetic type (called the tissue type or HLA type). Kidneys taken from living donors often begin to function immediately, while those from cadavers may take up to two weeks for tissues to adjust and become functional.
Unlike the backlog of patients in other medical areas, renal transplants happen when the donor kidney becomes available. On average, patients who are listed for a deceased donor transplant wait approximately three years, but there is a great deal of variability in this. For example, for a patient with a rare tissue type, there will be fewer donors with a tissue type that matches that of the patient well, compared to patients with more common tissue types. Furthermore some patients have antibodies directed against certain tissue types, which means that some, or even most, donor kidneys are not suitable for these patients.
After surgery, patients can expect to be hospitalized for approximately 7 to 10 days. After being discharged patients are seen daily as an outpatient for approximately four weeks. After the daily outpatient visits patients are instructed to do no heavy lifting or exercise for 8 to 10 weeks. Patients who do not smoke or give up smoking, maintain a good body weight and exercise regularly are more likely to have many years of good quality life with a well functioning kidney.
