Kidney Failure Treatment: What Doctors Don’t Tell You, But You Need To Know (Part 2)

Today is part two of my three-part series “Kidney Failure Treatment: What Doctors Don’t Tell You, But You Need To Know”. I hope you gained some valuable insights in the first article, but more importantly, acted on those tips.

If you missed the first article, you may find it here: Kidney Failure Treatment Part 1

In today’s article, I will be going through dialysis and transplants as a method of kidney failure treatment. These two treatments are the last resort that the medical community uses, and rightly so, they can be extremely intrusive, costly, and complicated.

Each of these treatments comes with its inherent risks and benefits, so it is important to understand what these are before making a decision that ultimately changes your life. As you would know by now I am an advocate of natural medicines over medical drugs and treatments, but that doesn’t mean I am anti-western medicine. I think there is a time and place for everything, and I believe that the fusion of Western medicine with traditional medicine (natural medicine) is the best treatment possible for end-stage-kidney-failure.

Kidney Failure Treatment

Dialysis

Dialysis is always the first treatment presented to those with kidney failure – it is less intrusive and is considered easier on the client compared to transplant (though that is debatable).
There are currently two methods of ‘dialysis’, the most common being hemodialysis, the other known as peritoneal dialysis.

Hemodialysis

Dialysis is really quite amazing – a medical marvel. In the case of hemodialysis, it is literally where a machine cleans your blood, removing creatinine, urea, excess fluid, potassium, phosphorus, sodium, and other metabolites, through a process of diffusion and ultra-filtration.

Invented in 1943 using sausage skins, beverage cans and the washing machine, Dr Willem Kolff created what is now the best treatment method available to modern medicine; thankfully it has come a long way from then however!

The hemodialysis process takes between 4-8 hours at a time, and most people require 2-3 sessions a week for the rest of their life (5 sessions a week in more serious cases). This is extremely demanding on one’s lifestyle as all treatments must be performed at a hospital, and therefore thorough weekly planning is needed.

Peritoneal dialysis

Peritoneal dialysis (PD) on the other hand is a daily home procedure, requiring 4-5 exchanges a day, taking roughly 45mins for each exchange.

Invented in 1969, and just as clever in my opinion as the moon landing of the same year, peritoneal dialysis has saved millions of lives and uses the body’s own tissue to recreate what the haemodialysis machine and kidneys do – blood filtration.

PD is a therapy for individuals with significant chronic kidney disease. The procedure uses a permanent tube in the abdomen (near the belly button – navel) to utilise the individual’s peritoneum like a membrane layer across which bodily fluids and dissolved substances (creatinine, urea, potassium, phosphorus, sodium, etc) are exchanged from the blood. The dialysate (exchange fluid) is drained into the abdomen and then flushed out in one continuous flow.

The Facts

I still encounter stories of people being kept in the dark about dialysis by their doctors. I believe the majority of doctors are not internationally secretive, they just believe that they know what’s best for the patient and therefore decide for the patient which dialysis is for them, and therefore do not disclose the full benefits, downsides, and risks of each dialysis method.

This is by no means an exhaustive list, but it does touch on some information that may help you in making an informed decision. “Everyone’s life is unique, and so are their decisions.”

Here are the top facts about dialysis:

• Peritoneal dialysis has a slightly lower mortality rate (this is a benefit) compared to hemodialysis.
• In some countries, the government will pay 80 per cent of costs associated with dialysis treatments.
• About 90 percent of dialysis patients receive hemodialysis
• Dialysis needs to be considered when your kidney function is at 15%, and seriously considered when at 10% function.

According to statistics, kidney dialysis (of both types) survival rates are as follows:

Polycystic kidney disease
• 1 Year – 94%
• 5 Years – 70%
• 10 Years – 42%

Glomerulonephritis
• 1 Year – 88%
• 5 Years – 58%
• 10 Years – 37%

High Blood Pressure
• 1 Year – 77%
• 5 Years – 33%
• 10 Years – 14%

Diabetes
• 1 Year – 71%
• 5 Years – 29%
• 10 Years – 11%

Kidney Transplant

A kidney transplant is the final treatment that the medical profession has to offer. It is by far the most complex of procedures, involving a lot more risks. However, those who are lucky enough to receive a kidney with minimal to no surgical complications and no kidney rejection by their immune system truly have a life that is near normal. Unfortunately in most cases, this is not the case.

Kidney transplants involve a donor, either from a “brain-dead” cadaver body, or a living donor – which is usually a relative or loved one.

The operation is a relatively simple procedure; however, it is after the operation that is the biggest challenge. A transplanted kidney may be “rejected” by the recipient’s immune system when it discovers that the transplanted kidney is a “foreign” body. This immune response may occur at any time so it can be a bit disconcerting for the recipient – as they never quite know if this complication will occur. The only safeguard to this occurring is highly powerful immunosuppressive drugs – and it is these drugs that create the biggest risks of the entire treatment. Because these drugs suppress the immune system so well, they can open up the body for any number of infections of varying severity. Not only that, but immunosuppressive drugs have several other side effects such as depression, osteoporosis, high blood pressure, cancer, peptic ulcers, liver injury, loss of appetite, nausea or vomiting, fatigue, increased hair growth, trembling or shaking of the hands, and kidney damage!

The Facts:
• The waiting time for a kidney is two years, however, because the waiting list is not a “queue” it could be a lot sooner or longer for you.

According to statistics, kidney transplant survival rates are as follows:
(Stats from United Network for Organ Sharing, 2003)

Kidney Transplant from Cadaver
• 1 Year – 93.7%
• 2 Year – 91.6%
• 5 Years – 80.6%
• 10 Years – 58.9%

Kidney Transplant from Living Donor
• 1 Year – 97.6%
• 2 Year – 96.4%
• 5 Years – 90.4%
• 10 Years – 77.8%

As you can see survival rates are a lot better when compared to dialysis, and those numbers have been steadily improving over the last few decades; this is due to improved immunosuppressive drugs, but with that comes the side effects of the drugs.

There are a couple of points on these kidney failure treatments that I believe are important to note. Firstly, one in five dialysis patients voluntarily withdraw from dialysis as a treatment, this is because dialysis can be such a burden mentally and physically on patients that they just prefer to go without… This is important to note, because dialysis is not a cure-all, and is not a walk in the park. You want to make sure you never have to decide on either dialysis or a kidney transplant. And this is possible – depending on the current health of your kidneys of course – through prevention, and the use of excellent dietary and natural medicine practices. Those of you who are already on dialysis (or on the verge of it), please do not let this information depress you, that is completely not my aim. Maybe it will inspire you to do all that you can to improve and preserve your current kidney function (through diet and natural medicines), or maybe it will inspire you to try a different dialysis method that is more aligned with your needs, and not your doctor’s.

…And secondly, the longer one stays on dialysis the likelihood of an unsuccessful kidney transplant is increased (including diminished survival rates) – that is of course if one does decide to have a kidney transplant. What to take from this? Well, if you are unsure if you want a kidney transplant put your name down anyway. That way you have a choice when a donor arises. If you leave it too late to put your name down on the recipient list you may miss altogether, or you may receive a kidney well into your dialysis treatments and therefore statistically your survival rate diminishes (but really, it needs to be said, you are not a statistic! – so who knows how it will play out for you).

Again this article series is not to be seen as “the” authoritative guide for kidney failure treatment, its purpose is to outline the main treatments for kidney failure, while at the same time providing snippets of information that are not widespread; and hopefully making your decisions that little bit easier and informed.

Well, that’s it for today, and I look forward to finishing off this series next week. In the meantime “love your body, love your kidneys”.