Thursday, October 29, 2009

Why may I need a kidney transplant?

Why may I need a kidney transplant?


When a patient has kidney failure, it causes him or her to feel ill. Over time, waste products and fluid build up in the body. This may result in death if untreated. There are three treatment methods for patients with End Stage Renal Disease (ESRD). The first is hemodialysis, where blood is passed through a dialysis machine and filtered in the same way as done by functioning kidneys. Another technique is peritoneal dialysis, which works by passing special fluid into the abdomen. Some of the toxic chemicals in the blood pass into the fluid. After a couple of hours the fluid is drained along with the toxins. A kidney transplant is the final means of replacing a failed kidney.

End Stage Renal  disease (ESRD) is also known as Chronic Kidney disease (CKD) in the 5th stage. The kidney's function of filtering removing toxins from the body is diminished. This function is called the Glomerular filtration rate. All individuals with a Glomerular filtration rate (GFR) <60 mL/min/1.73 m2 for 3 months are classified as having chronic kidney disease, irrespective of the presence or absence of kidney damage. The rationale for including these individuals is that reduction in kidney function to this level or lower represents loss of half or more of the adult level of normal kidney function, which may be associated with a number of complications.


All individuals with kidney damage are classified as having chronic kidney disease, irrespective of the level of GFR. The rationale for including individuals with GFR 60 mL/min/1.73 m2 is that GFR may be sustained at normal or increased levels despite substantial kidney damage and that patients with kidney damage are at increased risk of the two major outcomes of chronic kidney disease: loss of kidney function and development of cardiovascular disease.

Stage 1 CKD

Slightly diminished function; Kidney damage with normal or relatively high GFR (>90 mL/min/1.73 m2). Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.
Stage 2 CKD
Mild reduction in GFR (60-89 mL/min/1.73 m2) with kidney damage. Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine test or imaging studies.

Stage 3 CKD
Moderate reduction in GFR (30-59 mL/min/1.73 m2). British guidelines distinguish between stage 3A (GFR 45-59) and stage 3B (GFR 30-44) for purposes of screening and referral.

Stage 4 CKD
Severe reduction in GFR (15-29 mL/min/1.73 m2) Preparation for renal replacement therapy

Stage 5 CKD
Established kidney failure (GFR <15 mL/min/1.73 m2, or permanent renal replacement therapy (RRT), or Kidney transplant patient

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