What about dialysis?
While dialysis can be life-saving, it is only a stop-gap. It is a long, tiring, physically and emotionally draining process that is very hard on the body. Dialysis can do only about 10% of the work that a functioning kidney can do and frequently causes other severe health problems such as anemia, infection, bone disease, heart disease, and nerve damage. Consequently, the average life expectancy of a person on dialysis is only about 5 years.1 One out of every 4 patients on dialysis dies of a heart attack. "The unintended consequence of being attached to a kidney machine each week, often for the rest of your life is horrific," says Dr. W. Gifford-Jones, noted medical-column author for over 30 years.1A Fifteen to 25% of dialysis patients die annually. 1B
A transplant provides a far longer life expectancy. Patients who have a transplant before dialysis becomes necessary live an average of 10–15 years longer than those on dialysis.2 As one physician notes, “Kidney dialysis is an amazing procedure. But it is not yet as amazing as the kidney itself.” 3 Given thefoptions, a kidney patient’s best chance for survival is to avoid dialysis altogether and to receive a transplantffrom a living, rather than a deceased donor. (See The Best Option: A Living Donor.)
Equally significant, dialysis is an unpleasant experience for many. Nausea, vomiting, cramps, dizziness, and constant fatigue are common. Patients must follow a severely restricted diet that excludes common foods such as cheese, oranges, and tomatoes. Most patients must be dialyzed three days a week, 4 hours at a time. Dialysis centers usually operate around the clock; patients who are employed frequently must arrive at the center at 4AM, dialyze until 8AM, arrive at their place of employment already exhausted, and then put in a full day's work--only to repeat the cyle 48 hours later, 3 times each week, week after week. Those who are unemployed are sometimes required to follow the early-morning or a midnight-to-4AM schedule in order to accomodate the center's master schedule. Taking a business trip, vacation, or honeymoon requires finding a dialysis center in the travel area; in order to be worked into an away-from-home center's schedule, arrangements must sometimes be made months in advance. Most dialysis patients' lives revolve around dialysis.
Some patients can dialyze at home. For those able to dialyze at night, the treatment requires 8-10 hours. Those who dialyze during daytime hours must do so 4 times throughout the day. Home-dialysis patients must maintain scrupulously clean conditions in the treatment area, devote large amounts of space to storing equipment and dialysis solution bags, and follow the same dietary restrictions as those who dialyze at a center. Some require an assistant to set up and monitor treatment.
As might be expected, it is not uncommon for dialysis patients to develop mental-health issues such as depression. Some patients eventually choose to go off dialysis, preferring death to a life they find difficult to enjoy. While a kidney transplant is not a cure and carries its own disadvantages and complexities, it frees a patient from daily treatment regimens, dietary restrictions, physical discomfort, constant fatigue, and the knowledge that he or she must be tethered to a machine or mechanical equipment in order to live. Quality of life is far better with a transplant than dialysis.
Not to be overlooked is the fact that a transplant is tremendously more cost-effective than dialysis. While a transplant is by no means inexpensive, it is far less costly than dialysis: The average cost of a transplant--which can extend a patient's life by ten to twenty or more years--is between $100,0004 and $259,000.5 lThe cost of one year of dialysis is about $72,000.6 lThese costs affect nearly everyone--from employers and employees who pay health-insurancefpremiums, to individual patients and their families, to taxpayers, who fund Medicare andfSocial Security (for which end-stage kidney disease patients, regardlessiof age, are eligible).
Given its significantly increased life expectancy, lifestyle advantages, and cost-effectiveness, a kidney transplant is clearly the best alternative for those with end-stage kidney failure.
1,2 Beth Israel Medical Center/Harvard Medical School 1A Dr. W. Gifford-Jones, QMI Agency 1B Science Codex, 2/14/13 3 MedicineNet.com 4 Ohio State University Pre-Transplant Orientation, 2/9/10 5xWalllStreetlJournallMarket Watch, 6/11/09 6 MillimanlResearchlReport:l2008lU.S,lOrganlandlTransplantlCostlEstimates
