End Stage Kidney Disease and Transplant: General Information

A kidney transplant is:

surgery to receive a healthy kidney from a donor (living or dead).
for patients with kidney failure or end stage renal (kidney) disease (ESRD).

Most people are born with two kidneys.

Your kidneys filter (or clean) your blood. Kidneys send waste and extra fluid from your blood to your bladder. The waste and fluid then leave your body when you urinate (pee).

If your kidneys don’t work, the waste and extra fluid stay in your blood.

Kidney Failure

The two types of kidney failure are:

acute kidney injury - there are many different causes and they can often be treated without a transplant
chronic kidney disease - a condition that slowly gets worse until the kidneys stop working.

End Stage Renal Disease (ESRD)

ESRD is when the kidneys completely stop working and cannot filter and remove waste.

ESRD can be caused by:

Diabetes – Too much glucose (sugar) in the blood can damage the kidney’s filters. A protein called albumin can then get past the damaged filters and go through the blood into the urine. (The first sign of kidney disease is often protein in the urine.)
Hypertension (high blood pressure) – Hypertension is when blood pushes against the walls of blood vessels with too much force. This can damage blood vessels in the kidneys. The damaged kidneys cannot filter waste and fluid. (Extra fluid can also cause high blood pressure.)
Glomerulonephritis – This disease damages the kidney’s filters (glomeruli). Protein gets past the filters and into the blood then urine.
Polycystic Kidney Disease – With this genetic disorder, cysts can grow in the kidneys. The cysts can cause high blood pressure and problems with blood vessels in the brain and heart.
Autoimmune diseases (Lupus, Goodpasture’s Disease, etc.) – These diseases cause the body’s immune system to attack its own cells and organs.

Alport’s Syndrome, infection, drug toxicity, heavy metal poisoning, hemolytic uremic syndrome in children, IgA vasculitis, chronic dehydration, and renal artery stenosis can also cause ERSD.

Common symptoms of ESRD are:

High blood pressure
Changes in how much you urinate (pee)
Swelling of feet and ankles
Fatigue
Drowsiness
Itching or numbness in your body
Dry skin
Headaches
Weight loss
No appetite
Nausea
Vomiting
Trouble sleeping
Trouble concentrating
Darkened skin
Muscle cramps

Learn more about kidney disease in Resources.

Treatment Options for Patients with ESRD

Dialysis uses machines to filter the patient’s blood. There are different options for dialysis. Ask the patient’s doctor why type of dialysis is best for them. If the patient is eligible, the doctor will refer them for a transplant evaluation.
Kidney transplant from a living or deceased (dead) donor.

Kidney Transplant Waitlist

Patients who are eligible for kidney transplant might wait a long time for a kidney. The wait time depends on:

How long they have been on dialysis,
Their blood type,
If they are compatible with a kidney from a donor (tested by antigens and antibodies)
Previous transplants,
If they are waiting for a kidney from a living or dead donor, and
If they are a child.

Learn about national policies for kidney transplant wait time and allocation.

Ask your transplant team about increased-risk donors.

Patients who accept organs from increased-risk donors usually wait less time for an organ.
An increased-risk donor is a deceased donor with higher risk of spreading one of the following undiagnosed diseases to a transplant patient (Abara et al., 2019):
- human immunodeficiency virus (HIV),
- hepatitis B, or
- hepatitis C (HCV).
Organs from increased-risk donors are not lower quality.

Living Donor Kidney Transplant

A living person can volunteer to donate a kidney. Healthy adults without kidney disease or other medical problems can live a long, healthy life with only one kidney.

End Stage Kidney Disease and Transplant: General Information

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