Kidney Failure – When Do You Need a Transplant

Kidneys are important organs in one’s body and perform variety of functions most notably removal of toxins and metabolic wastes. Failure of the kidneys results in accumulation of these metabolic waste which creates havoc in human body.

Broadly kidney failure can be classified as – (1) Acute Renal Failure (ARF), when the kidney fails suddenly over period of hours to days. This is usually seen in ICUs, in critically ill patients. The good part is that these kidneys tend to regenerate and resume their normal functions over 4 – 6 weeks. During this period patients might require dialysis. This type of failure is temporary and not permanent. Hence patients with ARF do not require Kidney Transplant.

Your GFR highlights the stage of your kidney disease:

The second type is Chronic Kidney Disease (CKD) where kidney failure happens over periods of weeks to months. This type of failure is permanent and non-reversible. CKD has been classified into 5 stages depending on the amount of kidney function which is estimated by Glomerular Filtration Rate (GFR). Normal GFR in healthy adult is > 90 ml/min. CKD stages are from stage 1 to stage 5. Stage 1 is when GFR is > 90 ml/min with urinary abnormalities, Stage 2 when GFR is between 60 – 89 ml/min, Stage 3 when GFR is between 30 – 59 ml/min and Stage 4 when it is between 15 – 29 ml/min. CKD stage 5 is termed when GFR is < 15ml/min and this is the time patients require Renal Replacement Therapy which can be either Kidney transplant of Dialysis.

So, patients with CKD Stage 5 i.e. when kidney function is < 15 ml/min and the kidneys have been permanently damaged will require Kidney transplant. However, there are certain prerequisites also for a patient to undergo Kidney Transplant. The patient should be free from any active infection, should have no active substance abuse and should be motivated for transplant as he will have to continue with medications lifelong.

Discuss your Kidney Transplant with your Nephrologist:

It is important for you to discuss your medical details and options with your Nephrologist. Your decision whether you want to go ahead with a Kidney Transplant or not should be supported by your Nephrologist. Also clear your apprehensions about your health, post transplant life and quality of life.