Dialysis vs. Kidney Transplant

by Dr. Nageswara P Reddy | Feb 20, 2023 | Nephrology

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5.Which is the better treatment approach?

Dialysis or kidney transplant? Which one is better? Choosing between dialysis and a kidney transplant can be a difficult decision for people suffering from kidney disorders such as chronic kidney disease (CKD) and severe kidney failure. The choice is not a straightforward one and it depends on various factors. To make an informed decision, it’s essential to consider the advantages and disadvantages of each treatment option. To gain a more comprehensive understanding, let’s take a closer look at the pros and cons of these two widely popular treatment approaches.

What is Dialysis?

Dialysis is typically recommended for people with kidney failure, a condition in which the kidneys lose about 85 to 90 percent of the kidney function and have a glomerular filtration rate (GFR) of less than 15. Dialysis is not a cure for kidney failure, but it can help to keep the patient’s body in balance and prolong their life. Dialysis life expectancy is estimated to be 5 to 10 years, but in occasional cases, people have lived for 20 to 30 years.

It is a medical treatment that is used to remove excess waste, salt, and water from the blood in people whose kidneys are not functioning properly. It also helps in keeping a safe level of certain chemicals in the blood, such as potassium, sodium and bicarbonate and also keeping Blood Pressure under control. There are two main types of dialysis: hemodialysis and peritoneal dialysis.

What is hemodialysis?

Hemodialysis is a treatment that uses a machine to filter the blood outside of the body. During hemodialysis, a patient’s blood is passed through a special filter called a dialyzer, which removes excess waste, salt, and water from the blood. The clean blood is then returned to the body. Hemodialysis is typically performed in a hospital or a dialysis centre and requires the patient to be hooked up to the machine for 3 to 5 hours at a time, three times a week.

Here are some pros and cons of hemodialysis:

Pros:

Hemodialysis can effectively remove waste and fluid from the blood, which can help to improve the symptoms of kidney failure and prolong life.
Hemodialysis is performed in a medical facility, so it is supervised by trained healthcare professionals.
Hemodialysis can be done on an outpatient basis, so patients can continue to live at home while receiving treatment.

Cons:

Hemodialysis requires a patient to travel to a medical facility for treatment, which can be inconvenient and time-consuming.
Hemodialysis can be physically and emotionally draining for patients, as it requires a long commitment of time (usually several hours) for each treatment.
Hemodialysis can cause side effects such as low blood pressure, cramping, and fatigue.

What is peritoneal dialysis?

Peritoneal dialysis is a treatment that uses the lining of the abdomen (called the peritoneum) to filter the blood. During peritoneal dialysis, a special fluid called dialysate is introduced into the abdomen through a small tube. The dialysate absorbs excess waste, salt, and water from the blood and is then drained out of the body. Peritoneal dialysis can be performed at home and requires the patient to do several exchanges of the dialysate each day.

Here are some pros and cons of peritoneal dialysis:

Pros:

Peritoneal dialysis can be done at home, so it is more convenient for patients than hemodialysis.
Peritoneal dialysis allows patients to have more control over their treatment schedule and can be less physically and emotionally draining than hemodialysis.
Peritoneal dialysis does not require the use of needles, which can be an advantage for some patients.

Cons:

Peritoneal dialysis may not be as effective as hemodialysis at removing waste and fluid from the blood, especially in patients with advanced kidney disease or in patients with no urine output.
Peritoneal dialysis can be difficult in very obese patients and with past history of abdominal surgeries side effects.
Peritoneal dialysis requires the use of a catheter, which can be a potential source of infection.

What is kidney transplant?

A kidney transplantation is done in the case of nonfunctional kidneys. A kidney transplant is a surgical procedure in which a healthy kidney from a donor is implanted into a person who has kidney failure. The purpose of a kidney transplant is to replace the function of the failed kidneys with a healthy kidney from a donor.

Kidney transplantation is one of the most popular life-saving procedures for people with renal failure as it can increase the quality of life and prolong their lifespan. However, it is not a suitable treatment option for everyone with kidney failure. In order to be eligible for a kidney transplant, a person must meet certain medical criteria and be in overall good health.

There are two main types of kidney transplantation:

Living-donor transplantation: The donor is typically a family member or close friend of the recipient.
Deceased-donor transplantation: The donor is a person who has died and whose family has agreed to donate their organs.

Here are some pros and cons of kidney transplantation:

Pros:

Kidney transplantation can improve the quality of life and prolong the lives of people with kidney failure.
A kidney transplant can allow a person to stop dialysis and return to a more normal lifestyle.
A kidney transplant can be more effective at removing waste and fluid from the blood than dialysis.

Cons:

Kidney transplantation is a complex and risky procedure that requires careful medical management before and after the transplant.
Finding a suitable kidney donor can be difficult, and there is often a long waiting list for a transplant.
After a kidney transplant, a person must take immunosuppressive medications to prevent their body from rejecting the transplant. These medications can have side effects and weaken the immune system.
There is a risk of complications from the surgery, such as bleeding, infection, and rejection of the transplant.

It is important to discuss the pros and cons of kidney transplantation with a healthcare provider to determine if it is a suitable treatment option for one’s individual needs and circumstances.

Did you know the success rate of a kidney transplant in India is 90–95%?

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Which is the better treatment approach?

Kidney transplantation is generally considered to be a better treatment option for most people with kidney failure compared to dialysis. This is because a transplant can provide several benefits over dialysis, including:

Improved quality of life: A transplant can allow the patient to live a more normal life and return to activities that may have been difficult or impossible while on dialysis.
Greater independence: A transplant allows the patient to be less reliant on a treatment schedule and to have more flexibility in daily activities.
Maximum life after kidney transplant: Studies have shown that people who receive a kidney transplant tend to live longer than those who receive dialysis.
Better kidney function: A transplant can provide better kidney function compared to dialysis, which can help improve the overall health and well-being.

However, a kidney transplant is not for everyone. It’s also worth noting that a kidney transplant does not cure renal disease, and the patient will have to take drugs for the rest of the life to keep the body from rejecting the donated kidney.

Even though kidney transplantation has won the debate, it is crucial to highlight that the treatment strategy is determined by various criteria, including the patient’s age, the cause of the kidney disease, his overall health, whether or not he consumes alcohol on occasion, and his lifestyle choices. Other considerations, such as finding an appropriate donor, his financial situation, and his willingness to face the risk, may also be significant. Before making a decision, it is important to discuss and carefully analyse all treatment alternatives, as well as their possible dangers and advantages with the doctor.