Most healthy people have two kidneys. Healthy kidneys are fist-sized and are located in the back on either side of the spine. They remove extra water from the body and filter the blood to remove some waste products. The kidneys also help control blood pressure and minerals in our system, and assist the production of red blood cells.
When a person's kidney function begins to fail, they have a condition called chronic kidney disease (CKD)3.
When someone develops CKD, waste products and extra fluid can build up in the body. People usually feel fatigued, tired and may get puffy feet, ankles and face (edema). Food does not taste the same and the appetite is sometimes poor. Although everyone is different, the buildup of waste products creatinine and a form of nitrogen (BUN) measured in the blood tests often tell your doctor the degree of CKD. Your doctor may decide to start medicines to combat the effects of CKD depending on the test results.
People who have CKD may not feel ill until the disease is very far along. If you have CKD it is important to have regular medical checkups and blood tests. Diabetes and high blood pressure are the most common causes for CKD, but many more rare diseases can cause the kidneys to slow down. About one in nine people has some type of kidney disease, although far fewer of these people end up needing dialysis or a transplant.
Although many different illnesses can cause CKD, patients usually progress to the point where they need the help of dialysis treatments to feel better or even stay alive. Dialysis replaces the function of the diseased kidneys and allows people to function and thrive without working kidneys. Dialysis does not exactly match normal kidney function.
A kidney transplant can provide a replacement for kidney function that is more natural, freeing patients from dialysis treatments. The kidney transplant operation places a single new (third) kidney in the abdomen, leaving the original kidneys alone (unless they have been previously removed for other reasons). This transplanted kidney does the work of the two failing ones. The advantages of transplantation come with a very important string attached: every person who gets a transplant must take their medicine every day in order to keep the transplant working normally. The more patients understand about their medicines, the easier it is to stay on schedule.
Transplant patients regularly need adjustments in their medicines and always need to undergo blood tests to monitor kidney function. The transplant operation does not "cure" people of kidney disease because they still must take medicine and see the doctor regularly.
Kidney transplants are not for all patients with CKD. A kidney transplant is considered an "elective" operation. Some patients have conditions that make a transplant impossible or unsafe to perform. For these people, dialysis is the better option.
Some patients have a working kidney transplant that loses function over time. The expected survival for a transplanted kidney from a living donor is 11 to 13 years and from a deceased donor is nine to 10 years. A person can undergo evaluation for a second transplant when their original transplant fails.
3 Older terms for this include renal failure, end-stage renal disease (ESRD) or kidney failure.